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Family dynamics in the context of serious illness

In considering cancer as an illness that affects not only the patient but their entire family, recent research offers further insight into the depth of this impact and the complexity of culture, specific family challenges, and the patient–carer dyad. This chapter offers a model of family-centred care to encourage an understanding of the impact of illness on the family, the family in the caregiver role, and the needs of family-based caregivers. From a clinical perspective, the authors offer a guide for assessing these families for interventions, including the use of open communication and information provision, the recognition of past patterns of relating, the encouragement of acceptance of support, discussions with the family as a whole, and support during unpreventable emotional suffering that families experience. Specific interventions described include preventive and supportive interventions, interventions that challenge dysfunction, and interventions with the family when a patient is dying. Family-centred care is challenging as a paradigm but a useful harness to improved quality of life, one that warrants the effort involved to ease the suffering of all.