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The supportive relationship between palliative patients and family caregivers
  1. Geraldine Foley
  1. Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin, Ireland
  1. Correspondence to Dr Geraldine Foley, Discipline of Occupational Therapy, School of Medicine, Trinity Centre for Health Sciences, Dublin 8, Ireland; foleyg3{at}tcd.ie

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Family caregiving in palliative care is defined broadly as the process in which family members or loved ones provide unpaid care for a terminally ill family member in need of assistance. The care recipient may be a member of the caregiver’s family of origin or his or her family of choice, such as a friend or life partner.1 Fiscal constraints in formal care provision means that patients in palliative care are now increasingly dependent on family members for care.2 Indeed, a growing expectation that family members be involved directly in end-of-life care3 4 are likely to increase demands placed on family caregivers in palliative care.

Family caregivers in palliative care assume multiple caregiving roles. They may provide day-to-day physical care to their terminally ill family member.5 Although the psychosocial and existential situation of family caregivers in palliative care are not routinely evaluated,6 family caregivers in palliative care also provide emotional, psychological and existential support to their family member.7 In palliative care, the patient and family are viewed as the unit of care. Family caregivers can be directly involved in the delivery of complex interventions to patients, effectively operating as an extension to formal services. Family caregivers also participate regularly in the decision-making process for palliative care interventions (eg, symptom management, advance care planning, counselling) and can function as key advocators and care co-ordinators for the patient. Not surprisingly, perhaps, burden of care for family caregivers in end-of-life care has shown to be severe and …

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