The assessment and management of family distress during palliative care.
OBJECTIVE
In the advanced stages of illness, families manage multiple caregiving demands while facing the emotional task of preparing for the loss of their loved one. Palliative care settings are well suited to identifying families at risk for elevated distress, and providing support as they navigate this process. This review summarizes current research in the assessment and management of family distress at the end of life.


RESULTS
The recent literature on families of terminally ill cancer patients has provided a more precise description of the relational and cultural factors that contribute to family distress. Studies eliciting the perspectives of family members on what is needed at the end of life affirm the importance of supportive communication and continuity of psychosocial care into bereavement. Other developments include efforts to establish guidelines for conducting family meetings in the palliative care setting, and to train palliative care practitioners in family-centered assessment techniques. Finally, there is a limited but growing evidence base for the utility of delivering family-focused psychosocial interventions during palliative care.


CONCLUSIONS
The knowledge gained from current research on what is most salient to family members during palliative care is critical for ensuring effective delivery of supportive services and collaborative engagement in those services.
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10022, USA. zaidert@mskcc.org
Talia
T
Zaider
David
D
Kissane
D017028:Caregivers / Q000523:psychology; D005190:Family / Q000523:psychology*; D006117:Grief; D006801:Humans; D010166:Palliative Care; D011368:Professional-Family Relations