The parent who is left: why the surviving parent's wellbeing matters

When a parent dies, the parent who is left is grieving too, and is now raising the children on their own. Research finds that this parent's warmth, consistent discipline and own mental health are among the clearest protective factors for bereaved children, and that support aimed at the parent can help both parent and child^[1][2]. Most of that evidence comes from one long-running US trial, and almost no country measures how surviving parents themselves are doing.

After a death, a family's daily life tends to rest on one adult. That parent has to manage the funeral, the paperwork, the money and the school run. They also have to answer children's questions and notice how each child is coping, all while grieving their partner. Bereavement services see this every day. This study sets out what research from several countries shows about the wellbeing of surviving parents, why it matters for children, and what support for parents has been shown to achieve. It is about what parents need, not about how well they cope: the evidence describes pressures and protective factors, not success or failure.

The surviving parent is grieving too, and the strain shows in their health

A 2007 review in The Lancet concluded that bereavement is associated with excess risk of death, "particularly in the early weeks and months after loss"^[6]. A meta-analysis of 15 prospective cohort studies, covering 2,263,888 people, found that widowed people had 1.41 times the risk of dying in the first six months after their spouse's death, compared with married people, and 1.14 times the risk after that. The excess was larger for men (1.23 times) than for women (1.04 times). There was no significant difference between people younger and older than 65^[5]. These are relative risks from observational studies: they show an association, not proof that the death itself caused the difference, and they do not report separately on parents with children at home.

Studies of parents who are raising children after a partner's death are much smaller. In Sweden, 42 parents of children under 18 were surveyed two to four years after their partner died of cancer. The authors found that "a substantial proportion" of them reported moderate to severe symptoms of anxiety, post-traumatic stress and depression. Symptoms of prolonged grief were less common^[7]. In a US study of young people whose parent had died suddenly, the caregivers of those who went on to develop depression had higher rates of depression and post-traumatic stress disorder themselves^[8].

Beyond studies like these, the picture is thin. A US qualitative study of 12 young widowed parents, first published in 2023, noted that "few studies have examined widowed parents' grief experiences and parent-child interactions following a co-parent's death"^[9]. As far as we could find, no country's official statistics report the mental or physical health of widowed parents raising children as a group. Nordic registers could do this in principle, but we found no study that has. That gap is part of a wider one, described in our study of the missing official data on bereaved children.

Warm, steady parenting is one of the clearest protective factors

Bereaved children differ widely in how they fare, and researchers have asked what distinguishes those who do well. In a US study of 179 children and adolescents whose families had sought preventive services after a parent's death, 44% were classed as resilient and 56% as affected by at least one clinically significant problem. Among the family-level factors that set the resilient children apart were "higher levels of caregiver warmth and discipline and lower levels of caregiver mental health problems"^[1].

Other analyses from the same US research programme point the same way. In 313 bereaved children, positive parenting acted as a protective resource: children who experienced more positive parenting had fewer mental health problems, whether the children or their caregivers did the reporting^[10]. A study of 214 families tested whether a caregiver's psychological distress affects children partly through parenting. The cross-sectional data supported this, but the three-wave longitudinal model did not. Positive parenting at one point did predict children's mental health 11 months later^[11].

Not every study finds a strong link. In the Netherlands, a study of 159 bereaved children and one caregiver each found that caregivers' depression and anxiety had "a very small, yet significant" association with two of the children's outcomes. Children's own thoughts about the death and avoidance were more strongly linked to their grief and post-traumatic stress^[12].

Read together, these studies do not say that a child's wellbeing depends on one adult alone. They say that the surviving parent's capacity to stay warm, steady and well is a protective factor that support can reach, and one that the death itself puts under strain.

A parent's grief and a child's grief are linked

Grief is a normal response to a death, not a disorder. For some children and adults, though, it stays intense for a long time. The clearest evidence on how a parent's grief and a child's grief relate comes from a US study that followed 182 children and adolescents aged 7 to 18 whose parent had died suddenly. The researchers found three distinct patterns of grief over time. In one group, 10.4% of the sample, grief reactions "showed no change 33 months after death"^[13].

The study also found that prolonged grief in the children, in the adolescents and in the surviving caregiver predisposed children to a higher risk of new depression^[13]. In a seven-year follow-up of 216 young people bereaved by a sudden parental death, the peak incidence of depression came in the first two years after the death^[14].

This is an association, measured in one country, and it does not mean a parent's grief causes a child's difficulties. Families share the same loss, the same changed household and often the same money worries, all of which affect everyone in them. What it does suggest is that a parent and child's grief are best understood together. The authors drew that conclusion themselves: efforts to help bereaved children "also should assess and address grief reactions in the surviving parent"^[13]. Our studies of prolonged grief disorder in children and mental health after a parent's death cover the children's side in more depth.

Supporting the parent helps the child: evidence from trials

The strongest evidence that the surviving parent's wellbeing matters comes from trials that set out to support it. The best known is the US Family Bereavement Program. Its trial randomised 156 families, with 244 children and adolescents aged 8 to 16, to the programme or to a self-study comparison. The programme ran separate groups for caregivers, for adolescents and for children. Straight after the programme, it "led to improved parenting, coping, and caregiver mental health". At 11 months, children's emotional and behavioural problems were lower, but only for girls and for those with more problems at the start^[2].

The effects on parents lasted. Among the 131 parents whose spouse or partner had died, those in the programme had lower levels of depression, general psychiatric distress, prolonged grief and alcohol problems six years later than parents in the comparison group^[15]. The benefits also held across parents in different circumstances: "only 3 of 45 tests of moderation were significant"^[15].

Fifteen years on, the children were adults. Major depression was found in 13.46% of those whose families had taken part in the programme, against 28.05% in the comparison group. The trial reported an odds ratio of 0.332 for major depression^[3][4]. In an editorial in the same journal, two US researchers called the effect "as large or larger than many of our evidence-based treatments for depression"^[4]. Further analyses found that improved parenting just after the programme was associated with more support-seeking and greater perceived parental warmth 11 months later, both of which were related to personal growth after the loss at 6 and 15 years^[16].

This is one trial, in one country, first reported in 2003. The researchers who ran it also carried out the follow-ups, and the families had chosen to seek help. The results may not carry over to other countries, to families who do not come forward, or to support delivered in other ways. Even so, the wider trial evidence points the same way. A 2017 systematic review of support programmes for bereaved children and their caregivers included 17 studies, 15 of them randomised controlled trials. It found medium effects on "parental warmth, positive parenting, parent's mental health", and concluded that "studies have shown positive effects for both children's and remaining caregiver's health"^[17].

Work is now under way to test whether the parent component travels. In Germany, researchers are translating and adapting the programme's parent group, Resilient Parenting for Bereaved Families, for parents whose co-parent has died of cancer. In the planned pilot, parents will take part in 10 group sessions, described as biweekly, on-site or online. The study protocol notes that "such manualised interventions are missing for the German context"^[18]. Other researchers have proposed building self-compassion training for caregivers into family bereavement programmes. They describe it as "a resilience resource for multiple adaptive outcomes for themselves and for their child", though this has yet to be tested in outcome data^[19]. Our study of what helps bereaved children looks at the wider range of support.

Parents and children often protect each other by staying quiet

Numbers say little about what surviving parents themselves describe. A 2025 systematic review brought together 15 qualitative studies from nine countries on the support experiences and needs of bereaved children and surviving parents. From the parents' side, it found three themes: adjusting as a parent, supporting their children, and getting access to support for themselves. One finding cut across both groups: "Both children and parents suppress emotions and avoid conversations to protect each other and those around them." The review also found that "a taboo around death exists and constrains the support some families receive", and concluded that "childhood bereavement is a public health issue"^[20].

Information helps. In the Swedish study of widowed parents, those who said they had received more information during their partner's illness, about its effects and about where to find support, reported fewer psychological symptoms two to four years after the death^[7]. That is a link found in one survey, not proof of cause. But it points to something health services already control: what they tell families while a parent is still alive.

What the evidence asks of us

The evidence points clearly in one direction: support for bereaved children is stronger when it includes the parent who is left. That has practical consequences for the people who plan and fund services.

• Treat the surviving parent as part of the child's support, not separate from it. The researchers behind the US sudden-death study concluded that efforts to help bereaved children "also should assess and address grief reactions in the surviving parent"^[13]. Services that see only the child may miss one of the few protective factors they can strengthen.
• Fund support for parenting after a death, and evaluate it outside the US. The best trial evidence comes from one US programme^[3][15]. Adaptations like the German pilot^[18] are how other countries will learn whether the same benefits hold for their families.
• Start before the death where the death is expected. Swedish parents who received more information during their partner's illness reported fewer symptoms later^[7]. Hospital and hospice teams caring for a parent with children at home are well placed to provide this.
• Count surviving parents. No country we found routinely reports on the health of widowed parents raising children. Countries with population registers could study it directly, as they already do for bereaved children.
• Make it easier to talk. Parents and children often protect each other by not talking, and a wider taboo around death limits the support families get^[20]. Schools, health services and communities share the job of making support easier to ask for.

Language: this piece uses plain words such as “died” rather than euphemisms, because they are clearer. It uses “surviving parent” for the parent who is left, and “caregiver” where a study used that term for the adult raising the children. Grief is a normal response to a death; where this piece refers to depression, post-traumatic stress or prolonged grief, it means the conditions or symptom levels the studies measured.

Why we're publishing this

Bereavement services, hospices and schools often meet the surviving parent first, and know how much rests on them. Yet the evidence that supporting the parent helps the child is scattered across journals. We have brought it together so that the organisations working with bereaved families can make the case for supporting the whole family, and for counting how surviving parents are doing. It is part of our research library on children bereaved of a parent.

How to read this data

Most of the figures here come from the United States, and many from a single research programme: the Family Bereavement Program trial and studies of the families who took part in it^[1][2]. These families had sought help, so they are not a representative sample of all bereaved families. Smaller studies come from Sweden^[7] and the Netherlands^[12], and the qualitative review covers nine countries^[20]. The widowhood mortality figures pool cohort studies of widowed adults of all ages and do not separate out parents of children^[5].

Most studies here are observational: they show associations, not causes, and families who share a loss also share many other pressures. The 15-year depression figure comes from a randomised trial and is expressed as an odds ratio (0.332), with the percentages taken from an accompanying editorial^[3][4]. Where we could see only a study's abstract, we used only what the abstract reports. We found no official statistics, in any country, on the health of surviving parents raising children; that absence is itself a finding.

Use this data

Free to cite with attribution to Understanding Bereavement. Charities, schools, services and journalists are welcome to reuse these figures and charts. For the underlying figures as a spreadsheet, get in touch.

Important: This study summarises published research about groups of people for general information. It is not medical advice or bereavement support, and it cannot describe or predict anything about an individual child or family. If you are worried about a child or about yourself, please speak to a GP or another qualified professional.

Sources

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