The family is inevitably
involved in care-provision when one of its number suffers from a
life-threatening illness such as advanced cancer. Distress reverberates
throughout the family, with moderate rates of psycho-social morbidity. There
has been growing awareness over recent years of the importance of a
family-centered model of care to fully meet the requirements of clients and
families involved with palliative care services and, furthermore, maintain
continuity of support into bereavement.
As I have noticed, there are
some physical aspects of caring in a family environment. It is common for my
client with cancer to remain at home for much of her care. As she became less
able to carry out her usual tasks and care for herself, family members found
themselves in the role of caregivers. This meant that their daily life had
My client, once being
diagnosed as such, went through various crisis moments along the trajectory of her
illness. The initial diagnosis of cancer is one, and the diagnosis of relapse
is another. Cancer treatment, be it of curative or palliative intent, was a
demanding period for the client and family both physically and emotionally. As
the disease advances, disabilities and symptom progression were major sources
of sufferings. Finally, when facing death, anticipatory grief was overwhelming.
It goes without saying that
the family members, being with my client, were also facing their own stresses
and changing roles which may be directly or indirectly related to the client’s
illness. The family went through the grief process before and after my client’s
death. The cancer illness, therefore, became a family matter.
The family members were
crucial in maintaining the wellbeing of my client at home. The wellbeing of the
client in turn affected that of the HCA. When my client was not communicable or
unable to speak for herself, the family acted as the proxy or surrogate for
reporting symptoms and making medical decisions.
Therefore, my client’s family
members were HCAs and a care receiver. They had multiple roles, which were
potentially conflicting and challenging. They were facilitator or a barrier
during the care process at the same time.
Besides, the people close to my
client played a significant role in ensuring that the patient received
high-quality care as they near the end of life, in both community and hospital
settings. Many parents, other close relatives, as well as paid and unpaid HCAs,
were involved in discussing issues with the client, enabling her to make
choices, supporting her to communicate their wishes, or participating directly
in their treatment and care. My clients’ relatives were granted legal power to
make healthcare decisions when my client had difficulties to make her own
The relatives required all
necessary information about the client’s diagnosis and about the likely
progression of the condition or disease, in order to help them provide care and
recognize and respond to changes in my client’s condition.
Furthermore, the importance of
spiritual needs in terms of palliative care should be underlined. The relatives
took into consideration a set of my client’s aspirations, convictions, values,
and beliefs. For that reason, the family members did their best to optimize the
client’s own resources in order to enable her to face up to a dying process.