Departure Anxiety

By Carl Pickhardt, Ph.D.

How does one deal with the decline and death of parents?

Frequently only children don’t feel lonely until they have to deal with their parents’ declining health, disabling disease, and death. As this earthly separation approaches or occurs, the only child can fear the experience of being left alone without the two people who may have been the most important in his or her life.

If the only child and parents have grown from being a close family in childhood and adolescence to being close friends during his or her adult years, dealing with the loss of this enduring, intimate companionship can be frightening to contemplate and difficult to bear. “When my parent died, the part of them that was part of my life died as well. After all these years, I still keenly feel the loss. Yes, I have my marriage and my own family, which I love, but it’s not the same because we don’t share all that history. My parents and I knew and loved each other for over fifty years. I was everything to them, and in a way they were everything to me.”

Whether or not we are only children, the inevitability of our parents’ death is something we all have to face. For most of us there are three stages to this loss: parents’ declining health, end care of parents, and the death of our parents.

Declining Health

As parental health declines with age and infirmity becomes apparent, the adult only child often begins to feel tremors of separation anxiety because he or she can no longer deny the approaching reality of parental loss.

Coupled with this departure anxiety, there is usually a heightened sense of obligation in the only child who wants to care for his/her parents as well as they cared for him/her. While gladly accepting this responsibility, the only child realizes one price of being an only child: there are no siblings with whom to share the demands of parental care. There is no brother or sister on whom to lean for solace and support. “The hardest part of caring for my parents is having to do it alone.”

To counteract the sense of isolation that an adult only child might feel, it is important for him/her to reach out for non-familial support as well as support from family members. Friends who can listen, empathize, and encourage can be just as comforting and even more helpful than family. In addition, it is important to use whatever elder care services are available. Now there are also elder care support groups in many neighborhoods where adult only children can share resources, support, and special understanding during an emotionally complicated time.

Probably the hardest emotional challenge is defining how much help parents need. The key to arriving at that definition is knowing the difference between doing all one can and doing all one could. “ What is so difficult is wanting to do more for my parents than I am able and then feeling badly about myself for not living up to the standard of care I have set. Finally, I end up both exhausted for doing too much and blaming myself for not doing enough.” Setting limits means doing what one realistically can, not all that one ideally could.“

Caring For Parents At the End

When a parent’s poor health or disability requires the only child to place a parent in a nursing facility for full-time care, tremendous guilt can set in. “I feel like I defaulted on my responsibility to my parent when I placed him/her in the care of others who will never care as much about him/her as I do.”

Departure anxiety can take a turn for the worse when an adult only child feels helpless to provide for parents whose medical needs become acute and lack of comfort become painfully obvious. There are several points that can be helpful to remember: 

The quality of care your parents will receive in any facility will always be a compromise between all you wish to have provided and what the facility is able and willing to give. 

To support a high quality of care, visit often and create a sense of family presence. The residents with the most frequent visits tend to get the best care. 

Personally cultivate a positive relationship with management and attending staff so they are happy to see you, understand that you appreciate their efforts, are eager to give you information, and are willing to take suggestions that will make your parent more comfortable. 

The most important thing for your parents to know at this difficult time is that while what you can do for them has limitations, your love for them continues to be boundless.

Death of Parents

For an only child losing beloved parents can feel like abandonment: “I don’t know how to face the rest of my life without their companionship and care.” This sense of loss can also feel profound for adult only children who have been estranged from parents. “What I miss is not the parents I had but the parents I wish I’d had. Now the door to recovering that loving possibility is closed forever.”

The only child who was blessed with an ongoing loving relationship with parents must mourn honestly and come to terms with an emotional acceptance of a great loss. In this painful process the only child might keep in mind that there are some positive things on the other side of loss. 

  • The other side of grief is gratitude.

The magnitude of loss is testament to the magnitude of love that was given. 


  • The other side of absence is presence.

It is the sense of absence that keeps loving memory alive. The adult only child is able to move forward filled with loving recollections he or she can always cherish. 

  • The other side of loss is freedom.

Now freedom from care and concern for parental welfare can bring a measure of relief while freedom for investing loving energy elsewhere can begin to expand.