SUPPORTING THE FAMILY AND CARERS

RELEVANCE TO PALLIATIVE CARE

Having an understanding of the patients family context, in terms of family structure and close relationships, has a particular relevance in palliative care practice. Palliative care nurses today need to respond to the needs of people from a range of family forms, some that are traditional and others that might not conform to the conventional view of family.

FAMILY DYNAMICS

In dealing with a life-limiting progressive illness, shifts and negotiations in family roles will occur and difficulties can be encountered as family members try to respond to fluctuating and often subtle changes in the ill persons condition. The dynamic and interdependent nature of the family has led it to be linked to systems theory, whereby a system is a complex of elements in mutual interaction. When this definition is applied to the families, it allows us to focus our attention on interactions among family members rather than merely observing individual family members separate from their wider family

SYSTEMS AND SUBSYSTEMS

While each individual family member is a complex system in their own right, each individual, in turn, forms a subsystem that exists within the family system. These subsystems profoundly influence the interactions that operate within the family. The family system is surrounded by external links such as friends, church, school and neighborhood. Understanding the complex interconnectedness of individuals and of whole-family systems can facilitate a more holistic and inclusive approach to

ILLNESS EXPERIENCE OF FAMILIES

Serious illness in a family member is a complex system that affects the whole family in terms of its relationships and interactions.

ILLNESS EXPERIENCE OF FAMILIES

SERIOUS ILLNESS IN A FAMILY MEMBER

CHANGES IN ROLES AND RELATIONSHIPS

SIGNIFICANT STRESS TO BOTH PATIENT AND CARERS

ILLNESS EXPERIENCE OF FAMILIES

In a study of the social networks of women with breast cancer it was found that cancer not only impacted upon identity of the patient but also affected the identities of their families and close social contacts. Whatever care setting, families dealing with a dying relative need practical, psychosocial, financial and spiritual support and they also need access to information and support.

THE EXPERIENCE OF STRESS

POTENTIAL STRESSORS Anticipated loss of the person Threats to the existing relationship The pain of seeing a loved person deteriorating and suffering from the symptoms of their illness The helplessness in terms of being able to make the sick person better The stress of assuming additional duties and new roles within the family.

COPING THEORY