Care of the relatives and close friends is an integral feature of
good palliative care
Meeting with relatives is an essential part of palliative care, whether at
home or in a hospice/hospital palliative care unit.
Good care of the patient helps the relatives cope, but they also have
their own needs and anxieties that must be addressed, including:
! to do with the patient’s illness and care
o what exactly is wrong with the patient
o why the patient is receiving certain treatment
o what will happen next
o what is the prognosis or life expectancy
o whether his illness is infectious or contagious
o about visiting in hospital
o about talking to children and friends about the patient’s illness
o how to deal with unsolicited advice from relatives and friends
! to do with care at home
o whether they can or should care for the patient at home
o what other people will think about their caring
o what professional help is available
o how long they will be able to care for the patient at home
o whether their health will be adequate for them to do this caring
o whether they will cope with any emergencies that might arise
o when to call the doctor and what help or advice to ask for
o how to give medications
o how to feed the patient
o whether they will be blamed if the patient has to be admitted to
hospital or hospice
o how to restrict home visitors without offending anyone
o what to say to visitors
o how to get some rest as the patient’s condition deteriorates
! to do with their own personal feelings and needs
o their own health but feel they cannot mention it
o family tensions and how to deal with them
o unresolved interpersonal problems from the past
o unresolved grief from a recent bereavement
! looking to when the patient dies
o whether they have " done the right thing "
o how to behave after the death
o how to arrange a funeral
o how they will manage—where will they live, who will care for them,
where will the money come from
o legal and financial matters
How should these anxieties be addressed?
! short meetings with the doctor and/or nurse
o to explain everything they want to know about the patient’s illness
and care
o to ask questions about the illness, treatment and details of what lies
ahead
o to ask for information about whatever agencies there are to assist
their caring
o to express their fears about the present and both the immediate
and distant future
o to talk about their own health and other needs
o to express any anger, resentment, and sadness about the illness
and care
o the relatives must feel these meetings are solely for them and their
problems
o most relatives and close friends will appreciate and benefit from
these short meetings
! family conferences
o useful/necessary for dysfunctional families or if family tensions are
high or there is feuding within the family
o should be chaired by the doctor with the nurse and social worker in
attendance
o the purpose of the meeting is explained and the absolute necessity
for all to contribute and to put personal feelings aside
o the whole family are given details about the patient’s illness,
investigations, treatment and prognosis then invited to ask
questions
o each family member is then invited to express their feelings,
including their anger
o the doctor can then explain how their anger or feuding is not only
not helping each of them at this painful time but also affecting the
final days of their loved one
o they are asked to put interpersonal differences behind them, to try
to love or at least tolerate each other, remembering that each of
them is suffering grief, disappointment and apprehension
o finally they are asked to appoint one person to be the
communications link between them and the treatment team
At every stage, the palliative care team must ensure that the relatives
are being given the care, the attention and the time they need