Issues of Death and Dying
for Adult Children of Holocaust Survivors
Paula David, MSW,
Coordinator, Holocaust Resource Project
Senior Social Worker
Baycrest Centre for Geriatric Care, Toronto, Canada
Presentation to
Council on Social Work Education
2003 National Gerontological Social Work Conference
Atlanta, February 2003
Issues of Death and Dying for Adult Children of Holocaust Survivors
Paula David, MSW,
Coordinator, Holocaust Resource Project
Senior Social Worker
Baycrest Centre for Geriatric Care, Toronto, Canada
No man is an Island, entire of itself; every man is a piece of the Continent, a part of the main; if a clod be
washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy
friends or of thine own were; any man's death diminishes me, because I am involved in Mankind; And
therefore never send to know for whom the bell tolls; It tolls for thee.
John Donne (1571 - 1631), Meditation XVI
Abstract
Today as the last of the survivors of the Holocaust are coping with the challenges of aging, their
adult children are dealing with the issues of death and dying and losing a special group of
people. This paper will examine the unique issues facing survivor families as the survivors age,
and report on a survey that examined survivor and non-survivor families’ responses to parental
loss. It will examine the issues, the qualitative feedback and the quantitative results. The
potential extrapolative information for survivors of subsequent genocides will be also be
considered
Introduction
Baycrest Centre for Geriatric Care, located in Toronto, Canada offers a comprehensive range of
services to the community's older adults. The Baycrest campus includes a complex continuing
care Hospital, the Jewish Home for the Aged, supportive Housing, Day Care Services and a range
of speciality services, community medical clinics and outreach programs.
A significant percentage of patients and clients are Jewish, and of those, almost half are survivors
of the Nazi Holocaust. The remnants of pre-war thriving European Jewish communities’
Holocaust survivors are now facing the challenges of the aging process. Once again themes of
loss intrude on all aspects of everyday life while survivors must cope with the health and social
changes associated with aging. The Holocaust and the impact it had on the survivors, their
families and humanity in general is a complex and never-ending area of study.
While the survivors of the Holocaust are now facing their own mortality, their children are
stepping forward to support their parents, care for them and mourn them. Research has shown
that survivor families often have unique commonalities and their children, the ‘second
generation’ also share a great deal in common. Children symbolized a “rebirth and restoration, a
justification for survival, a hope for meaning and vindication for suffering” (Safford, 1995). Not
only the shattered hopes and dreams of parents were invested in their children, but many of these
couples assumed and passed on the lost visions, dreams and potential of murdered parents,
siblings, grandparents and extended family. These overwhelming expectations created a need in
many of the second generation to try and “make up” for their parents’ losses and therefore led
these same children to experience frustration for never being able to fulfill this far reaching and
unrealistic task.
2
Considering that the label and meaning of their parents’ post-war existence is ‘survival’, the
concept of parental death and dying may generate unique anxieties for this group. Since they
became aware of parental identity, the children saw their parents as ‘survivors’ with the ability to
survive a genocide that killed almost everyone in their parents’ universe, the ability to survive the
loss of all material goods, the ability to survive deprivation, humiliation and victimization. Now,
decades later, their children must deal with the reality that their parents cannot survive terminal
illness or old age.
Despite the variants regarding the manner in which survivors of the Holocaust transmit their early
life experiences to their children, the children still have to confront the implications of their
parents’ aging. As their parents age, and when care demands and responsibilities increase, they
often have fewer practical resources to utilize. Survivor families often consist of a nuclear
family, the second generation often being raised without the extended support of aunts, uncles
and cousins. Most survivor families lack familial models of aging and have little experience with
the challenges, illnesses and consequences of aging. Institutional placement for elderly survivors
may precipitate great anxiety in their children.
Children of Holocaust survivors were born during or after the Holocaust to parents who suffered
extreme victimization at the hands of Nazis. Some children were born in Europe but most moved
and were raised in Israel, the United States, Canada, Australia, South Africa or South America
(Newman, 1979). “There is a special bond between survivor parents and their children born after
the Holocaust. Whether through shared dreams, fantasies or intricate reciprocal acting out in
fantasy, an illusion was created that parents and their post-persecution children had been together
before the latter’s birth…The child is a source of reassurance and confirmation of revival, while
at the same time bearing the traces of unmourned loss.” (Klein and Kogan1986). Rosenbloom
(1985) reports that adult children of aging survivors identify themselves as ‘heirs’ to the
Holocaust and want to be understood from within this perspective. This may be related to the fact
that family is a loaded concept for survivors of the Holocaust because of the total destruction of
the matrimonial families and extended members.
Various research surmises the uniqueness of bonds in Holocaust families (Rosenbloom, 1985,
Klein-Parker 1988). Children of Holocaust survivors have been perceived by their parents as the
meaning to continue living and the sole reason to exist (Pilcz, 1979). In turn, the children are
known to have feelings of burden and intense guilt in developing autonomy because of the pain
their parents endured during the cruel separation from the people they loved in earlier years
(Klein-Parker, 1988).
Children of Holocaust survivors have a unique role to play that has been reported to be both a
burden and a privilege (Klein-Parker, 1988). They know their parents lost their entire families and
chose to create new ones. They are cognizant that they are sometimes named after murdered
relatives and that their parents may compare them to lost loved ones including children. As such,
children of Holocaust survivors may assume more responsibility for their parents than children of
families who are not confronted with the atrocities of the Holocaust. Danieli (1988) reports that
“Children of survivors seem to have consciously and unconsciously absorbed their parents’
Holocaust experiences into their lives”.
Many children of survivors have integrated and internalized both the known and unknown
circumstances of their parents and may suffer from the trauma status that their parents face
(Safford, 1995). In some instances, children of Holocaust survivors disclose their involvement in
fantasy as a tool to understand what was done to their parents and how they survived (Safford,
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1995). Adult children are often troubled by guilt, a similar guilt experienced by their parents for
not being able to undo their parents’ early life trauma.
Similarly, literature discloses that other children report an inability to be given permission to have
stress and hardship in their own lives (Klein-Parker 1988, Newman 1979). This is seen to reflect
the understanding that no matter what the children confront in their life, it does not rank in
comparison to the extremity of their parents’ pain. As a result of feeling invalidated for their own
feelings towards their current life obstacles, these children may take on the need to suffer in order
to identify with their parents (Newman, 1979). These overwhelming expectations created feelings
in children to make up for their parents’ losses and therefore led these same children to
experience frustration for never being able to fulfil this far-reaching and unrealistic task.
It is interesting to realize that although children of survivors were generally born after 1945 and
never experienced persecution or abuse, they recapitulate their parents’ symptoms and behave in
a similar way to the survivors themselves (Klein-Parker, 1988). As previously mentioned,
children may incorporate their parents’ guilt. They may also feel an obligation to retell the
history of the Holocaust, and they may even have nightmares of persecution.
The preceding review of the literature is not intended to create a pathological consideration of
adult children of Holocaust survivors but rather works to create an awareness of the types of
relationship and affective responses to this type of trauma in families. In recent years, adult
children of Holocaust survivors have worked hard to reclaim their own experiences and feelings
in order to combat labelling and diagnosis that manifests as a result of the symptomology. Adult
children have raised social consciousness and often express a collective identity and the need to
work together to discuss, clarify and explore their feelings regarding their identity as ‘adult
children of survivors’. These same children emphasize strength, vitality and a high rate of
success. For instance, research reports children to disclose an ability to be inspired and dedicated
to responsibility because of their family constellations and the life-affirming attitudes by which
they were raised (Danielli, 1988). Today, they are caring for aging parents.
As the survivors age and their issues evolve with their respective mental and physical maturation,
so do the needs for innovative and resourceful responses. The early-life traumatic events
experienced by survivors of the Holocaust seem to have left an indelible mark on their children as
well. Vander Kolk (2000) defines the human response to psychological trauma as “one of the
most important public health problems in the world”. Kahana et al (1989) and Rosenbloom
(1985) suggest that as survivors of the Holocaust age their behavioral and cognitive functions are
affected in both particular and more acute ways than that of the overall aged population who did
not have similar life experiences.
As survivors grow older and are confronted with the stresses and challenges of aging, they
potentially face an exponential increase in vulnerability. In turn, their children also must cope
both with their parents’ issues with death and dying as well as their own. All adult children, in
mourning their parents’ death cope with the pain of inevitable separation, and this study was
conducted to establish whether the issues, mourning process and response to parental death
differed in adult children of Holocaust survivors.
Geriatric clinicians continually deal with issues of loss and mortality. Major illness, cognitive
impairment and institutionalization will have a critical impact on any older adult and his/her
family members, but for the Holocaust survivor there are additional elements. The DSM-IV
diagnosis of Post Traumatic Stress Disorder is based on six criteria, including re-experienced
trauma and disturbing symptoms. The categories take into account that symptoms may remain
4
latent for many years following the trauma, sometimes occurring following a ‘trigger’ event
(Allodi, 1994; Tomb, 1994). The ‘Survivor Syndrome’, based on the symptomatology of
Holocaust victims includes loss of self-esteem, survivor guilt complex, chronic anxiety,
helplessness and depression (Allodi 1994, Cohen, 1991). Not all survivors suffered from this
‘syndrome’ but they all had to learn coping and adaptive skills that would have been
inconceivable before the War. They literally came forth from the ashes to rebuild themselves and
their families.
Family life for survivors after the war took on many different meanings. Often couples came
together in efforts to survive and not because of love. Love was often not the impetus for couples
to marry. Instead goals such as mutual dependency, protectiveness and an ability to build a new
life fuelled many of these unions. Such relationships were often concentrated on the children
rather than on the intimacy in the intimate relationship (Hass, 1991). Family issues of separation,
intimacy and bonding are impacted by the environment of multiple losses that permeated all
aspects of family life. Survivor parents who were able to sustain love and warmth within the
family unit were able to support their children through their developmental phases. Parents who
were caught in their own struggles coping with their own trauma throughout their post-war lives
often have difficult relationships with their adult children. Regardless of the quality of the parentchild relationship, most children of survivors are extremely sensitive to their parents’ trauma
(Goldhar, David 2001).
These children also have to face their parents’ mortality. Compounding this anxiety is a
paradoxical familiarity with the concept of death, having being raised in a unique environment
where genocide is part of the fabric of family life. (David, 1998). They must also confront issues
of long-term care planning for their parents if they become ill or frail and the loss of one parent
while dealing with the other grieving parent among many other life changes. It is a difficult
situation for these children as they deal with the ‘normal’ realities surrounding aging parents
while feeling compounded by their experiences as children of survivors of the Holocaust.
As previously outlined, in many cases these adult children experience a transmission of their
parents’ early life trauma and the usual mixed feelings about the changing care needs and the
potential institutionalization of their parents are exacerbated. These potential issues may define
the family system of survivors of the Holocaust and their families and must be understood by the
clinicians who work with them.
As with their parents, it is also crucial to recognize the range of individual issues and perceptions
of the Holocaust from the perspective of survivors’ children. Family members are and should be
considered key participants in the care plan of their aging family members. In the case of
families of survivors of the Holocaust there are unique family issues that must be considered and
recognized by staff. Like their parents, the children of survivors cannot be assessed as a
homogeneous group, and professional staff must look to them for clarification and direction.
Based on mutual aid and mutual support, a group work approach for the second-generation is an
excellent non-intrusive approach to offering support (David, 1999). Discovering commonalties
amongst each other and a safe venue for discussing their fears, concerns, dismay and family
issues has proven very validating for the children of Holocaust survivors. (David, 2002)
The Baycrest Group for adult children of survivors of the Holocaust is called “Aging Parents,
Aging Children”. Initially when the Group was formed four years ago, the goal was to provide a
time-limited forum for social work staff and adult children of survivors of the Holocaust to share
information and concerns regarding the care issues of their parents. The Second-Generation
Group struggled with its early identity and eventually defined itself as an ongoing group that
5
would continuously reinvent itself. The group is an informal one, reacting to members’ stated
needs and themes of discussion.
The group best reflects a self-help paradigm, providing peer support and mutual aid in relieving
the stress related to difficult life situations. The adult children’s group deals either with caregiver
issues associated with their aging parents or the recent loss of an elderly parent. The children of
survivors are also aging, and by virtue of the trauma their parents shared, have unique
commonalties and Holocaust perspectives. Not only do these ‘children’ often have ambivalent
and unresolved feelings towards their parents or their parents’ experience, but also the threat of
losing parents increases their sense of vulnerability. Loss, whether expressed or repressed, has
been a shared theme in their lives.
The adult children of survivors are also dealing with family issues on a continuum. The SecondGeneration Group has used the long-term group as a surrogate family and initially developed
strong bonds based on mutual insights into their unique heritage. Disclosure in their group over
time has allowed each member to reconsider the impact the Holocaust has had both on their
parents and themselves. They have found a safe forum to discuss their conflicted emotions
regarding their parents and to examine a communal and collective guilt they had never discussed
openly before. Knowing the Group will be there for them as long as they need it, they feel safer
developing mutual trust and taking risks. Group members have underlined the unique
contribution adult children of survivors make to the quality of care their parents receive as well as
the importance of sharing the family caregivers’ and the survivors’ specialized needs. There is a
continuous ebb and flow in this group, where members have created a pattern for times of serious
introspection or painful disclosure, followed by periods of satire and humour. Members have
laughed and cried together and unanimously view both as therapeutic.
The issue of anticipatory mourning is frequently raised. Anticipatory mourning occurs before
death and it is often a result of terminal diagnosis where death is the outcome (Rando, 1986).
With the pending death of a family member the adult child begins to mentally prepare oneself and
begins to say goodbye. However, in the second-generation group it was discovered that many
members exhibited symptoms of anticipatory mourning even if their parents were not ill. Aging
in itself precipitated anticipatory mourning. This phenomenon is likely explained by the ongoing
theme of loss within survivor families
Since the Group’s inception, six members have lost their remaining parent, one member died, and
four members have had to institutionalize a parent. In each case, Group members felt that their
losses, their subsequent coping affected them differently because of their survivor family status.
In each case, Group members were there for each other providing practical and emotional
support, and were able to articulate the positive benefits of Group caring. Group members
consistently identified their reactions and emotions as ‘different from the norm’. Emotional pain
and degree of personal loss tend to be very subjective, so the survey was based on individual
perception with the compiled evidence providing insight to the group response. Parental loss is
an ongoing theme within the Group. Due to the growing demand for this type of mutual support,
in 2002 a second group was initiated and is evolving similarly to the first.
The rationale for this study was based on clinical evidence within the group and a direct outcome
of a perceived need to offer more sensitive clinical support to survivor families. It is an attempt
to quantify the sentiments being expressed over the years by the support group for adult children
of aging Holocaust survivors at Baycrest Centre, and echoed by the participants of an online
Internet Discussion Group for children of survivors. Group discussion in both venues
continuously reflected a sense of ‘difference’ and inordinate fear and anticipatory grief on the part
6
of children of survivors which seemed different than that of their non-survivor family
counterparts.
The study examines the issues, the qualitative feedback and the quantitative results. Ultimately
this discussion will lead to more sensitive care for a unique population that has already coped
with infinite trauma. As has been the case with much of the research concerning social issues
related to Holocaust survivor families, there is potential extrapolative information for survivors of
subsequent genocides.
In order to understand how survivor families respond to the challenges of parental loss and to see
how their response differed from non-survivor families, a questionnaire was developed.
Members of the Second Generation Group at Baycrest who had lost one or both parents
participated in the survey as well as offering qualitative responses. Members of the Internet
discussion group for children of survivors also completed survey forms and feedback was both
solicited and given online. If indeed survivor families respond and react differently than nonsurvivor families to the pending death or the actual death of a parent, those clinicians who care
for these families will have a better understanding of the issues.
The loss of a parent is a difficult one for any adult child. In order to understand potential
differences and see similarities in response, an equal number of questionnaires was distributed to
a comparator group whose parents were not survivors. Figures 1 (a & b) show the countries of
origin of both groups’ respondents. The children of survivor group indicates the international
flavour of the internet membership and since English is the designated language, the majority of
participants are from North America. The non-survivor respondents are mainly Canadian, for
reasons of accessibility, but all participants were invited and participated online. All participants
are middle-aged, have post-secondary education and have Jewish parents. The group of children
of survivors have one or both parents who survived the Holocaust… in most cases both. The
comparator group’s parents were either born in North America or left Europe before World War
II began.
Fig. 1a: 45 Adult Children of Survivors Respond
20
15
10
5
0
Canada
USA
Israe l
O the r
Countries
Fig 1b: 45 Adult Children of Jewish Parents who are not Survivors Respond
35
30
25
20
15
10
5
0
Canada
USA
7
Israel
Other
Countries
Figures 2 a & b are similar in that both groups were identified as having lost one or both parents
in order to participate in the survey. As the adult children in the survivor families were all
between 45-60 years old, a similar age group was solicited for the comparator group. This
population, regardless of parental country of origin has aging or deceased parents by virtue of
their own age.
Fig 2 a: Have you lost either or both your parents? (Survivor Families).
20%
one parent
both parents
80%
Fig. 2b: Have you lost either or both your parents? (Non-Survivor Families)
31%
One Parent
Both Parents
69%
8
Figures 3 a & b show a remarkable difference. Survivor families often consisted of the nuclear
family only, with perhaps a distant cousin or two. Surrogate families were often created with
fellow survivors, usually from the same town or county. These landsmen formed mutual benefit
societies in their new homes and acted as extended family. Therefore, the children of survivor
families often existed in these reconstituted family groupings where all parents were virtually the
same age. Therefore, all parents are aging and dying simultaneously. Families that did not
experience the Holocaust would have larger extended families with a more typical age range. It
is likely that children would experience within their extended family circles the normal life events
and passages, including funerals.
Fig. 3a: Had you ever been to a funeral before? (Survivor Families)
40%
yes
no
60%
“The first funeral I attended was when my uncle died when I was 19. My mother
didn’t want me to go, thought it would be 'upsetting'. I had no idea what it would be
like, and put on black clothes, like in the movies. When my parents came to pick me
up my mother screamed, 'Only Goys wear black to funerals' and made me change. I
think I was numb through the whole process, and just didn't know what I felt.”
(adult child of Survivor)
Fig 3b: Had you ever been to a funeral before? (Non-Survivor Families)
4%
yes
no
96%
9
“My first funeral ever was my grandmother’s. Within two years, the other three followed.
Each time, at each funeral, I looked to my parents for direction. In the case of all four, they
chose to celebrate life, so I did also. I had been close with all my grandparents, and have only
warm memories, which I cherish to this day .” (adult child of non-Survivor)
Figure 4 examines where bereaved adult children turn for help. There seems to be a marked
difference between the two groups in that survivors tend to turn to close friends more than nonsurvivors, who more readily turn to siblings. Survivors’ children do not seem to have the
resources for support in the older generation for reasons previously discussed, perhaps
explaining an increased use of professional help.
Figure 4: Who of the following supported you through the loss of your parent(s)?
Survivor Families
From My Generation:
Sibling:
14
Close friend:
(spouse)
Cousin:
Therapist :
Non-Survivor Families
31%
From My Generation:
Sibling:
9
21%
38
84%
Close friend (spouse):
15
33%
4
8
8.8%
17%
Cousin:
Therapist :
6
2
13%
4%
Outside my Generation:
Aunt or Uncle:
4
8.8%
Outside my Generation:
Aunt or Uncle:
8
18%
Friend of parents: 3
6.6%
Friend of parents:
11%
5
“My parents spoke very little about the Shoah or about death. It was always spoken of in
hushed tones and nothing was explained. We did not have a proper religious education. My
mother’s idea of teaching me about the Jewish rituals of death was to scream at me that she
was still alive when I walked around the house in my stocking feet. I had to go barefoot or
wear slippers. When I was 14 the roof caved in. My father died at the age of 41 after a three
month illness. My sister and brother were 10 and 7 years old. No-one explained
ANYTHING. At the gravesite, besides the spectacle of my mother almost falling into the
grave, I had to deal with the rabbi coming at me with a huge pair of scissors to cut my black
scarf. He did the same to my little sister. Mercifully he left my brother alone. Shiva was
explained to me when we got home after the funeral. Nobody told me anything: they had no
‘patience’ to explain anything. They had plenty of patience to talk to each other. As I write
this, I realize that none of the adults in my world thought of us as people. It had a profound
affect on who I am today.” (adult child of Survivor)
“When my father was diagnosed with cancer, we knew he was terminal. I was so desperate for
any emotional support, that I got into a disastrous personal relationship with a woman;
oblivious to the problems, because ‘she was there for me’. But, at least, unlike my immediate
family, she was ‘there’ for me when my father died. My being in ‘role’—the one counted on
to do arrangements, to ‘be there’ to ‘do the right thing’…9 years later still have not been able
to ‘feel’ all the emotional consequences of my father’s death.” (adult child of Survivor)
10
Figures 5 a & b are interesting in the significant differences in the two groups and how death
was explained or not.. to children. Also the number of parents of survivor families who did not
discuss their death underlines the paradoxical familiarity and distancing of the concept of death
and loss.
Figure 5a: When was your first opportunity to discuss your parent(s) pending
death? (Survivor Families)
9%
as a
child
31%
as
adult
at
death
7%
53%
never
Figure 5b: When was your first opportunity to discuss your parent(s) pending
death? (Non-Survivor Families)
4%
10%
30%
as
child
as
adult
at
death
never
56%
“My mother was dying of cancer and my father would only sit and hold her hand. I’d ask a
question, and he would shake his head. I didn’t even know where she would be buried. My
father told me in intimate detail more than I ever wanted to know about the death of six
million Jews. I didn’t even know what to do about the imminent death of one” (adult child of
Survivor)
11
Figures 6a & b demonstrate that parental loss generally impacts on how adult children discuss
death and dying with their own children. As with any major life event, it makes sense that
personal experience will deepen understanding and sensitize the individual. This fact seems to
have more consistency amongst survivor families.
Figure 6a: Did your experience of loss impact on how you discuss, or will discuss
death and dying with your children? (Survivor Families)
45
40
35
30
25
20
15
10
5
0
yes
no
somewhat
Figure 6b: Did your experience of loss impact on how you discuss, or will discuss
death and dying with your children? (Non-Survivor Families)
25
20
15
10
5
0
yes
no
somewhat
“I learned better ways to deal with death from my 2nd generation American husband. His
family did not make a mystery of it. I decided to try to do better and took my children to the
cemetery to visit my father’s grave. I spoke of him often. He is a real person to them, not like
my many dead relatives who are ghosts to me. I always took them on shiva (bereavement)
calls. They grew up understanding the rituals and most of all, not being afraid. My mother
used to tell me that I told them too much. I told her there was no such thing as telling them
too much. Nobody likes funerals, but they don’t have to scare you either.” (adult child of
Survivor)
12
Fig 7a: Since the loss of your parent(s) do you feel better able to cope with the loss
of a loved one? (Survivor Families)
11%
4%
yes
no
some
what
85%
Fig 7b: Since the loss of your parent(s) do you feel better able to cope with the loss
of a loved one? (Non-Survivor Families)
8%
yes
no
54%
38%
some
what
“Years after my father died, my mother's death didn't bring much more clarity to the concept
of mourning. We buried her next to my father but it still felt like we were performing rituals in my heart I recognized terror and loneliness - my built-in fear of abandonment had
turned true. Now, though, it is no longer a secret mystery.”
(adult child of Survivors)
“I think losing a parent is something that can’t be anticipated… only experienced. Now that
it has happened, I only feel more vulnerable. I realized that no matter how many funerals I
have attended and how many losses I have experienced, there is nothing that resonates like
losing a parent. My religion and the rituals provided a great comfort.” (adult child of nonSurvivors)
Conclusions:
Grief, loss and mourning are crucial components both of living and clinical practice in working
with older adults. How staff and families respond to older adults’ losses, illnesses and ultimately
their deaths, contributes both to the dignity of the process and the quality of the subsequent
13
bereavement and mourning period. The loss of a parent is traumatic for the child regardless of
age. While younger children obviously face a different range of losses from the very practical
protective aspect to the challenges of potentially losing the stability and security that is
associated with the parental role, it is still a traumatic loss for all ages. This survey has shown
the depth of loss felt amongst middle-aged adult children upon losing a parent and that the
impact of that loss is not diminished with age. The responses have also indicated that a large
proportion of adult children of Holocaust survivors have different perspectives on death and
dying. It would seem that survivors’ difficulties in speaking about their traumatic losses with
their children have subsequently impacted on their children’s abilities to cope with parental loss
Families of Holocaust survivors have fewer resources and less experience with issues of death
and dying. It is a paradoxical irony that this group of adult children is intimately familiar with
the death of so many, while the death of an elderly parent is shrouded in mystery. There are
important implications of this survey for professional caregivers in hospitals, nursing homes and
community settings that care for elderly survivors. Staff must be cognizant of the unique
sensitivities and vulnerabilities of this group when discussing prognoses, end-of-life directives
and bereavement issues in general.
There are also implications for children of survivors of subsequent genocides, and by examining
the issues of the children of Holocaust survivors, improved coping mechanisms might be
developed prior to experiencing difficulties. It is obvious that the children of survivors of
genocide and extreme war trauma must cope with an additional level of loss when their survivor
parent dies. Issues of grief and bereavement are coloured by their understanding of death, dying
and loss, often as taught them by their parents. The children of the Holocaust survivors have
demonstrated how professional healthcare providers must be aware of how parents’ personal
trauma impacts on their children. Like their parents before them, these adult children are coping
with losses beyond that of a parent, and also like their parents, they are often ill prepared to meet
the challenges.
The Nazi Holocaust and the impact it had on the survivors, their families and humanity in general
is a complex and never-ending area of study. The Holocaust is synonymous with visions of
multiple deaths and trauma. Today as the last of the survivors of the Holocaust are coping with
the challenges of aging, their adult children are dealing with the issues of death and dying and
losing a unique group of people. Adult children of Holocaust survivors continue to consider their
family lives and existence in the shadow of the Holocaust in order that they continue their
parents’ commitment to rebuilding shattered families. Regardless of the difficulties these adult
children face even after their parents’ death, they recognize and can articulate their challenges.
While their parents’ collective sorrow and trauma may be reflected in their world views, so is
their resilience, adaptability and ability to commit to the future.
14
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