When a Parent Is Dying: Global Study Reveals How Deprivation Reshapes Cancer Care for Families

When an adult with incurable cancer is also the primary caregiver for children under eighteen, the illness becomes a family event rather than an individual diagnosis. A new global qualitative study, published in BMC Medicine, has examined how health and social care professionals around the world experience the challenge of supporting such families when they are also living in deprivation. The research, led by Jeffrey R. Hanna of Ulster University and Cherith J. Semple, together with colleagues at the University of Strathclyde and other institutions, offers one of the most internationally broad pictures to date of what frontline workers see when poverty and terminal cancer collide in the same household.

The scale of the problem underpinning the study is stark. Globally, roughly one in twenty children experiences the death of a significant adult, such as a parent, before reaching adulthood. Cancer-related deaths are greater among families living in deprivation, and deprivation itself is defined in the study as a state of observable and demonstrable disadvantage relative to the local community or wider society. In other words, it is not simply an absolute measure of income but a relational one: a family can be deprived because of how far it falls behind the norms of the society around it, which shapes what it can afford, where it can live, and what kind of support it can realistically access during a terminal illness.

To capture professional perspectives across radically different health systems, the researchers conducted one-to-one semi-structured interviews with forty-four professionals drawn from twenty-three countries. Notably, more than forty percent of the interviews were conducted with professionals working in low- and middle-income countries, a deliberate design choice that prevents the findings from being dominated by high-income healthcare contexts. The interview data were analysed using reflexive thematic analysis, a qualitative method in which researchers actively acknowledge their own assumptions and position while identifying patterns across participants’ accounts. This approach is well suited to a topic in which cultural, religious and economic context profoundly alters what families need and what professionals can offer.

From the analysis, two central themes emerged. The first was described as intersectionality shaping the incurable cancer experience for families living in deprivation. The professionals did not understand deprivation as a single variable, such as low income, but as multi-faceted, with various dimensions intersecting and compounding one another. Religious, cultural, financial, educational, environmental and social factors all influenced how a family lived through an adult caregiver’s incurable cancer. A family’s faith community might shape how openly the illness is discussed with children; educational disadvantage might limit a parent’s ability to navigate paperwork or understand treatment information; poor housing or an unsafe environment might make it impossible to provide the stability that children need while a parent is dying.

The second theme concerned navigating family-centred supportive cancer care in the context of deprivation. Here the professionals were strikingly clear about a hierarchy of need. Before any broader psychosocial work could begin, such as conversations about the children’s understanding of the illness or their involvement in the dying parent’s care, a range of unmet basic needs had to be addressed. Housing and financial insecurity came first. A clinician cannot meaningfully explore with a mother how her children are coping with her prognosis if that mother does not know where the family will live next month or how it will eat. The study’s findings suggest that family-centred care, however well intentioned, fails when it is delivered on top of unmet fundamental needs rather than alongside practical solutions to them.

This sequencing has significant technical implications for how supportive cancer care is organised. Family-centred care as a model assumes that the clinical team can engage the whole household in communication, emotional support and shared decision-making. But the professionals in this study more often felt challenged in their clinical role about how best to support families living in deprivation, precisely because the model’s prerequisites were absent. They perceived an instrumental role for social workers, charities and non-governmental organisations in making family-centred supportive cancer care possible for this population. In effect, the clinical team’s ability to do its psychological and communicative work depended on a wider network of actors who could secure food, shelter and financial stability.

The professionals’ sense of being stretched beyond their clinical remit is one of the study’s most consequential findings. Oncology teams are trained to treat disease and manage symptoms, and many systems now include some psychosocial support, but the professionals described feeling ill-equipped and often unsupported when deprivation dominated the family’s situation. The gap they identified was not a lack of compassion but a lack of clear, accessible pathways between healthcare systems and the social care and community organisations that hold the practical levers. Where those ties are weak, families fall between services: the hospital treats the cancer, the family’s housing crisis remains unresolved, and the children’s needs go unaddressed until a crisis forces attention.

The study’s conclusions translate these observations into concrete recommendations. Stronger ties are needed between healthcare systems and social care and community organisations to enable clear, accessible pathways that address the basic needs of families living in deprivation who are experiencing incurable cancer. That includes providing food and housing security, as well as emotional, social, financial and practical support, such as ensuring legal guardianship arrangements for children. Guardianship is a detail that is easy to overlook in clinical settings but is devastating in its absence: if a parent dies without legal arrangements in place, children can face prolonged uncertainty about who will care for them, compounding grief with administrative and legal instability.

Equally important is the study’s emphasis on culturally sensitive family-centred communication that aligns with a person’s beliefs, values and social realities. Because the research deliberately included a majority of interviews from low- and middle-income countries, its findings resist a one-size-fits-all model of breaking bad news or involving children in a parent’s illness. What counts as appropriate openness with children, who should be present at the bedside, and how dying is discussed are all culturally embedded questions. Professionals need the flexibility and the training to adapt family-centred communication to each family’s worldview rather than importing a template developed in high-income, Western clinical settings.

The research was funded by the National Institute for Health and Care Research through an Applicant Development Award, with the funders having no role in study design, data collection, analysis or publication, and it involved patient and public involvement and engagement through a steering group that informed the recommendations. Ethical approval was obtained from Ulster University’s Research Ethics Committee, and all participants gave informed consent. As an open-access publication in BMC Medicine, the study makes its global evidence base available to clinicians, policymakers and service designers everywhere. Its central message is difficult to ignore: for families facing a parent’s terminal cancer in conditions of deprivation, the most urgent oncological intervention may not be medical at all, but a coordinated guarantee of food, shelter, financial stability and legally secure care for the children who will outlive the illness.

Subject of Research: Health and social care professionals' experiences of providing family-centred supportive cancer care to families living in deprivation when a parent has incurable cancer

Article Title: Health and social care professionals’ experiences of providing family-centred cancer care for families living in deprivation: a global qualitative study

Article References: Hanna, J. R., Anand, R., Paul, S., McCloy, K., Mhamane, S. V., Strutt, L., & Semple, C. J. (2026). Health and social care professionals’ experiences of providing family-centred cancer care for families living in deprivation: a global qualitative study. BMC Medicine. https://doi.org/10.1186/s12916-026-05157-4

Image Credits: AI Generated

DOI: 10.1186/s12916-026-05157-4

Keywords: cancer, palliative care, deprivation, family-centred care, parental cancer, health inequalities, qualitative research, social care, children, global health, psychosocial support, BMC Medicine