• Jackie Ellis, Chris Dowrick, and Mari Lloyd-Williams.
• Academic Palliative and Supportive Care Studies Group (APSCSG), Division of Health Service Research, University of Liverpool, Liverpool, UK.
• J R Soc Med. 2013 Feb 1; 106 (2): 576757-67.

ObjectiveTo explore the individual experiences of those who had experienced the death of a parent(s) before the age of 18, and investigate how such experiences were perceived to impact on adult life.DesignAn exploratory qualitative design using written (n = 5) and oral (n = 28) narratives and narrative analysis was adopted to explore the experiences 33 adults (7 men and 26 women) who had experienced parental death during childhood.SettingUK participants: Individuals living in the North West of England who had lost a parent(s) before the age of 18.Main Outcome MeasuresViews of adults bereaved of a parent before the age of 18 of impact of parental loss in adult life.ResultsWhile individual experiences of bereavement in childhood were unique and context bound, the narratives were organized around three common themes: disruptions and continuity, the role of social networks and affiliations and communication and the extent to which these dynamics mediated the bereavement experience and the subsequent impact on adult life. Specifically they illustrate how discontinuity (or continuity that does not meet the child's needs), a lack of appropriate social support for both the child and surviving parent and a failure to provide clear and honest information at appropriate time points relevant to the child's level of understanding was perceived to have a negative impact in adulthood with regards to trust, relationships, self-esteem, feeling of self-worth loneliness and isolation and the ability to express feelings. A model is suggested for identifying and supporting those that may be more vulnerable to less favourable outcomes in adult life.ConclusionsThe findings suggest that if the negative consequences are to be minimized it is crucial that guidelines for 'best practice' that recognize the complex nature of the bereavement experience are followed.

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