Medical Family Therapy in Palliative and Hospice Care

  • Jackie Williams-Reade
  • Stephanie Trudeau
Part of the Focused Issues in Family Therapy book series (FIFT)


Contemporary advancements in health care and medical technology are allowing patients to live longer now than they ever have before. We are seeing these trends in longer life across all age groups—from increased survival during childhood from illnesses that were heretofore rapidly fatal to combating normative age-related declines (and thereby prolonging senescence) in the elderly. With these trends come marked increases in the likelihood of being diagnosed with a serious or terminal illness during one’s lifetime (Centers for Disease Control and Prevention [CDC], 2011). Such illnesses and their unique health trajectories are generally treated under the medical specialties of Palliative and Hospice Care (CDC, 2010; Meier, 2011). Providers engaged in these treatment teams must attend to patients’ physical functioning within a context where getting better is not presumed. Treatment teams must thereby attend to foci like quality of life, emotional suffering, loss, meaning making, and spirituality as part of everyday practice.


Glossary of Important Terms in Palliative and Hospice Care

Advanced care planning

A process of communication between individuals and their healthcare agents to express wishes and preferences regarding care in the event they are unable to make their own decisions or speak for themselves (Waldrop & Meeker, 2012). MedFTs can help patients and family members engage in advance care planning that can help prevent unnecessary suffering and improve quality of life toward the end of life and can aid caregivers in better understanding what the patient prefers (Houben, Spruit, Groenen, Wouters, & Janssen, 2014). Several documents and resources scan assist in this process and are listed at the end of this chapter. The decisions made in advanced care planning are reflected in an advance directive.

Advance directive

A legal document that states your preferences regarding healthcare decisions in the event you are unable to speak for yourself. There are three main categories of advanced directives: “power of attorney,” “healthcare proxy,” and “living will.”

Allow natural death (AND)

A more recent terminology that can replace the DNR order. While a DNR /DNAR relates to CPR, an AND instructs that only comfort measures be taken to manage symptoms without interfering with the natural dying process.

Death with dignity

A term commonly used to describe a physician-assisted death, physician-assisted dying, aid-in-dying, or medical aid-in-dying. It includes a process that allows for certain terminally ill patients (adults) to legally consult and request a lethal dose of medication from their primary care providers. Patients receive said medication from a pharmacist and then take it themselves (or have a family member administer it) in order to end life in a peaceful and dignified manner. This option is only available in certain areas (see Death with Dignity, 2016).

Do not resuscitate (DNR)/Do not allow resuscitation (DNAR)

A medical order written by a primary care provider (Breault, 2011). It instructs healthcare providers not to do cardiopulmonary resuscitation (CPR) if a patient stops breathing or if his or her heart stops beating. The primary care provider writes the order only after talking about it with the patient (if possible), the proxy, or with the patient’s family.

Healthcare proxy

Designates an individual to make medical decisions on a patient’s behalf if they are unable.

Living will

Documents a patient’s desired wishes about medical treatment at the end of life in the event they are unable to communicate. It can also be called a “directive,” “healthcare declaration,” or “medical directive.”

Physician order for life-sustaining treatment (POLST)

A more recent form developed to improve communication about goals of care, quality of life, diagnosis, prognosis, and treatment options between seriously ill or frail patients and healthcare professionals about wishes pertaining to life-sustaining treatments. (Polst Organization, 2016).

Power of attorney

Authorizes an individual to make decisions on a patient’s behalf in the event they become disabled or incapacitated. A medical power of attorney authorizes an individual to make medical decisions for a patient in the event he or she becomes unconscious or mentally incapable of decision-making.


  1. Aoun, S., Currow, D., Hudson, P., Kristjanson, L., & Rosenberg, J. (2005). The experience of supporting a dying relative: Reflections of caregivers. Progress in Palliative Care, 13, 319–325. CrossRefGoogle Scholar
  2. Armstrong, B., Jenigir, B., Hutson, S. P., Wachs, P. M., & Lambe, C. E. (2013). The impact of a Palliative Care program in a rural Appalachian community hospital: A quality improvement process. American Journal of Hospice and Palliative Care, 30, 380–387. CrossRefPubMedGoogle Scholar
  3. *Babcock, C. W., & Robinson, L. E. (2011). A novel approach to hospital palliative care: An expanded role for counselors. Journal of Palliative Medicine, 14, 491–500.
  4. Bakitas, M., Kryworuchko, J., Matlock, D. D., & Volandes, A. E. (2011). Palliative medicine and decision science: The critical need for a shared agenda to foster informed patient choice in serious illness. Journal of Palliative Medicine, 14, 1109–1116. CrossRefPubMedPubMedCentralGoogle Scholar
  5. Bardia, A., Barton, D. L., Prokop, L. J., Bauer, B. A., & Moynihan, T. J. (2006). Efficacy of complementary and alternative medicine therapies in relieving cancer pain: A systematic review. Journal of Clinical Oncology, 24, 5457–5464. CrossRefPubMedGoogle Scholar
  6. Barnato, A. E., Anthony, D., Skinner, J., Gallagher, P., & Fisher, E. (2007). Are regional variations in end-of-life care intensity explained by patient preferences? A study of the U.S. Medicare population. Medical Care, 45, 386–393. CrossRefPubMedPubMedCentralGoogle Scholar
  7. Baucom, D., Porter, L., Kirby, J., Gremore, T., Wiesenthal, N., Aldridge, W., … Keefe, F. (2009). A couple-based intervention for female breast cancer. Psycho-Oncology, 18, 276–283.
  8. *Becvar, D. S. (2003). The impact on the family therapist of a focus on death, dying, and bereavement. Journal of Marital and Family Therapy, 29, 469–477.
  9. Berry, P., & Griffie, J. (2010). Planning for the actual death. In B. R. Ferrell and N. Coyle (Eds.), Oxford textbook of palliative nursing (pp. 629–644). New York, NY: Oxford University Press.Google Scholar
  10. Blank, T., Graves, K., Sepucha, K., & Llewellyn-Thomas, H. (2006). Understanding treatment decision making: Contexts, commonalities, complexities, and challenges. Annals of Behavioral Medicine, 32, 211–217. CrossRefPubMedGoogle Scholar
  11. Breault, J. L. (2011). DNR, DNAR, or AND? Is language important? The Ochsner Journal, 11, 302–306. Retrieved from PubMedPubMedCentralGoogle Scholar
  12. Breitbart, W., Gibson, C., Poppito, S. R., & Berg, A. (2004). Psychotherapeutic interventions at the end-of-life: a focus on meaning and spirituality. The Canadian Journal of Psychiatry, 49, 366–372. CrossRefPubMedGoogle Scholar
  13. Brickner, L., Scannell, K., Marquet, S., & Ackerson, L. (2004). Barriers to hospice care and referrals: Survey of physicians’ knowledge, attitudes, and perceptions in a health maintenance organization. Journal of Palliative Medicine, 7, 411–418.
  14. Campion, E. W., Kelley, A. S., & Morrison, R. S. (2015). Palliative care for the seriously ill. New England Journal of Medicine, 373, 747–755.
  15. *Center to Advance Palliative Care. (2016). About palliative care. Retrieved from
  16. Center to Advance Palliative Care. (2011). Public opinion research on palliative care. Retrieved from
  17. Centers for Disease Control and Prevention. (2010). End-of-life preparedness: An emerging public health priority. Retrieved from
  18. Centers for Disease Control and Prevention. (2011). Leading causes of death. Retrieved from
  19. Centers for Medicare & Medicaid Services. (2013). Medicare hospice benefits. Retrieved from
  20. Chochinov, H. M. (2006). Dying, dignity, and new horizons in palliative end-of-life care. CA: A Cancer Journal for Clinicians, 56, 84–103.
  21. Chochinov, H. M., Kristjanson, L. J., Hack, T. F., Hassard, T., Mcclement, S., & Harlos, M. (2007). Burden to others and the terminally ill. Journal of Pain and Symptom Management, 34, 463–471. CrossRefPubMedGoogle Scholar
  22. Claxton-Oldfield, S. (2015). Hospice Palliative Care volunteers: The benefits for patients, family caregivers, and the volunteers. Palliative & Supportive Care, 13, 809–813. CrossRefGoogle Scholar
  23. Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129–136. CrossRefPubMedGoogle Scholar
  24. Engel, G. L. (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137, 535–544. CrossRefPubMedGoogle Scholar
  25. Curtis, J. R. (2008). Palliative and end-of-life care for patients with severe COPD. European Respiratory Journal, 32, 796–803. CrossRefPubMedGoogle Scholar
  26. D’Antonio, J. (2014). Caregiver grief and anticipatory mourning. Journal of Hospice & Palliative Nursing, 16, 99–104. CrossRefGoogle Scholar
  27. Death with Dignity National Center (2016). FAQs about the Death with Dignity National Center. Retrieved from:
  28. *Doka, K. (1993). Living with life-threatening illness: A guide for patients, their families and caregivers. New York, NY: Lexington Books.Google Scholar
  29. Dumanovsky, T., Augustin, R., Rogers, M., Lettang, K., Meier, D., & Morrison, R. S. (2015). The growth of palliative care in U.S. hospitals: A status report. Journal of Palliative Medicine, 19, 8–15.
  30. Edwards, B., & Clarke, V. (2004). The psychological impact of a cancer diagnosis on families: The influence of family functioning and patients’ illness characteristics on depression and anxiety. Psychoncology, 13, 562–576. CrossRefGoogle Scholar
  31. Edwards, T., & Patterson, J. (2006). Supervising family therapy trainees in primary care settings: Context matters. Journal of Marital and Family Therapy, 32, 33–43.
  32. El-Jawahri, A., Greer, J. A., & Temel, J. (2012). Does palliative care improve outcomes for patients with incurable illness? A review of the evidence. Journal of Supportive Oncology, 9, 87–94.
  33. Emanuel, L. L., von Gunten, C. F., & Ferris, F. F. (Eds.). (1999). Module 12: Last hours of living in EPEC (Education on Palliative and End-of-Life Care) participant’s handbook. Princeton Township, NJ: Robert Wood Johnson Foundation.Google Scholar
  34. Engelman, S. R. (2013). Palliative care and use of animal-assisted therapy. Omega-Journal of Death and Dying, 67, 63–67.
  35. Erlen, J. A. (2005). When patients and families disagree. Orthopaedic Nursing, 24, 279–282. PubMedGoogle Scholar
  36. Evans, A. J. (1994). Anticipatory grief: A theoretical challenge. Journal of Palliative Medicine, 8, 159–165. CrossRefGoogle Scholar
  37. Evans, B., & Ume, E. (2012). Psychosocial, cultural, and spiritual health disparities in end-of-life and palliative care: Where we are and where we need to go. Nursing Outlook, 60, 370–375.
  38. Fadiman, A. (1997). The spirit catches you and you fall down. New York, NY: Farrar, Straus & Giroux.Google Scholar
  39. Feudtner, C., Womer, J., Augustin, R., Remke, S., Wolfe, J., Friebert, S., & Weissman, D. (2013). Pediatric palliative care programs in children’s hospitals: A cross-sectional national survey. Pediatrics, 132, 1063–1070.
  40. Figley, C. R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self care. Journal of Clinical Psychology, 58, 1433–1441. CrossRefPubMedGoogle Scholar
  41. *Galanti, G. A. (2015). Caring for patients from different cultures (5th ed.). Philadelphia, PA: University of Pennsylvania Press.Google Scholar
  42. Gallagher, L. M., Lagman, R., Walsh, D., Davis, M. P., & LeGrand, S. B. (2006). The clinical effects of music therapy in palliative medicine. Supportive Care in Cancer, 14, 859–866.
  43. Gamino, L. & Ritter, R. (2010). Ethical practice in grief counseling. New York, NY: Springer.Google Scholar
  44. Gonzalez, S., Steinglass, P., & Reiss, D. (1989). Putting the illness in its place: Discussion groups for families with chronic medical illnesses. Family Process, 28, 69–87.
  45. Gordon, T., & Mitchell, D. (2004). A competency model for the assessment and delivery of spiritual care. Journal of Palliative Medicine, 18, 646–651. CrossRefGoogle Scholar
  46. Grant, E., Murray, S. A., Kendall, M., Boyd, K., Tilley, S., & Ryan, D. (2004). Spiritual issues and needs: Perspectives from patients with advanced cancer and nonmalignant disease. A qualitative study. Palliative & Supportive Care, 2, 371–378. CrossRefGoogle Scholar
  47. Grassi, L. (2007). Bereavement in families with relatives dying of cancer. Current Opinion in Supportive and Palliative Care, 1, 43–49. CrossRefPubMedGoogle Scholar
  48. Guldin, M., Vedsted, P., Zachariae, R., Olesen, F., & Jensen, A. B. (2011). Complicated grief and need for professional support in family caregivers of cancer patients in palliative care: A longitudinal cohort study. Support Care Cancer Supportive Care in Cancer, 20, 1679–1685.
  49. Hanratty, B., Hibbert, D., Mair, F., May, C., Ward, C., Corcoran, G., … Litva, A. (2006). Doctors’ understanding of palliative care. Palliative Medicine, 20, 493–497.
  50. Hardy, K., & Laszloffy, T. (1995). The cultural genogram: Key to training culturally competent family therapists. Journal of Marital and Family Therapy, 21, 227–237.
  51. Harstäde, C. W., Andershed, B., Roxberg, Å., & Brunt, D. (2013). Feelings of guilt: Experiences of next of kin in end-of-life care. Journal of Hospice & Palliative Nursing, 15, 33–40. CrossRefGoogle Scholar
  52. Hebert, R. S., Prigerson, H. G., Schulz, R., & Arnold, R. M. (2006). Preparing caregivers for the death of a loved one: A theoretical framework and suggestions for future research. Journal of Palliative Medicine, 9, 1164–1171. CrossRefPubMedGoogle Scholar
  53. *Himelstein, B., Hilden, J., Boldt, A., & Weissman D. (2004). Pediatric palliative care. New England Journal of Medicine, 350, 1752–1762.
  54. Ho, A. H. Y., Cecilia, L. W. C., Pamela, P. Y. L., Chochinov, H., Neimeyer, R., Pang, S. M. C., & Tse, D. M. W. (2013). Living and dying with dignity in Chinese society: Perspectives of older palliative care patients in Hong Kong. Age and Ageing, 42, 455–461.
  55. *Hodgson, J., Lamson, A., Mendenhall, T., & Tyndall, L., (2014). Introduction to medical family therapy: Advanced applications. In J. Hodgson, A. Lamson, T. Mendenhall, and D. Crane (Eds.), Medical family therapy: Advanced applications (pp. 1-9). New York, NY: Springer.Google Scholar
  56. *Hodgson, J., Lamson, A., & Reese, L. (2012). The biopsychosocial-spiritual interview method. In D. Linville and K. Hertlein (Eds.), The therapist’s notebook for family health care: Homework, handouts, and activities for individuals, couples, and families coping with illness, loss, and disability (pp. 3–12). New York, NY: Haworth Press.Google Scholar
  57. Holland, J. C., Kash, K. M., Passik, S., Gronert, M. K., Sison, A., Lederberg, M., … Fox, B. (1998). A brief spiritual beliefs inventory for use in quality of life research in life-threatening illness. Psycho-Oncology, 7, 460–469.<460::AID-PON328>3.0.CO;2-R CrossRefPubMedGoogle Scholar
  58. Houben, C. H., Spruit, M. A., Groenen, M. T., Wouters, E. F., & Janssen, D. J. (2014). Efficacy of advance care planning: A systematic review and meta-analysis. Journal of the American Medical Directors Association, 15, 477–489. CrossRefPubMedGoogle Scholar
  59. Hudson, P., Aranda, S., & McMurray, N. (2002). Intervention development for enhanced lay palliative caregiver support: The use of focus groups. European Journal of Cancer Care, 11, 262–270.
  60. Hudson, P., & Payne, S. (2011). Family caregivers and palliative care: Current status and agenda for the future. Journal of Palliative Medicine, 14, 864–479.
  61. Hudson, P., Quinn, K., O’Hanlon, B., & Aranda, S. (2008). Family meetings in palliative care: Multidisciplinary clinical practice guidelines. Bio Med Central Palliative Care, 7, 1–12.
  62. Hudson, P., Remedios, C., Zordan, R., Thomas, K., Clifton, D., Crewdson, M., … Bauld, C. (2012). Guidelines for the psychosocial and bereavement support of family caregivers of palliative care patients. Journal of Palliative Medicine, 15, 696–702.
  63. Hughes, M. T., & Smith, T. J. (2014). The growth of palliative care in the United States. Annual Review of Public Health, 35, 459–475.
  64. Irwin, S. A., Rao, S., Bower, K., Palica, J., Rao, S. S., Maglione, J. E., … Ferris, F. D. (2008). Psychiatric issues in palliative care: Recognition of depression in patients enrolled in hospice care. Journal of Palliative Medicine, 11, 156–163.
  65. Johnson, K. S. (2013). Racial and ethnic disparities in palliative care. Journal of Palliative Medicine, 16, 1329–1334.
  66. Jones, B. L. (2006). Pediatric palliative and end-of-life care. Journal of Social Work in End-of-Life & Palliative Care, 1, 35–62. CrossRefGoogle Scholar
  67. Karlsson, M., Friberg, F., Wallengren, C., & Öhlén, J. (2014). Meanings of existential uncertainty and certainty for people diagnosed with cancer and receiving palliative treatment: A life-world phenomenological study. BMC Palliative Care, 13, 28–37.
  68. Kaur, J., & Mohanti, B. K. (2011). Transition from curative to palliative care in cancer. Indian Journal of Palliative Care, 17, 1–5.
  69. Kissane, D. W., & Bloch, S. (2002). Family focused grief therapy. Philadelphia, PA: Oxford University Press.Google Scholar
  70. Kissane, D., McKenzie, M., McKenzie, D., Forbes, A., O’Neill, L, & Bloch, S. (2003). Psychosocial morbidity associated with patterns of family functioning in palliative care: Baseline data from the family focused grief therapy controlled trial. Palliative Medicine, 17, 527–537.
  71. Kissane, D., McKenzie, M., Bloch, S., Moskowitz, C., McKenzie, D., & O’Neill, L. (2006). Family focused grief therapy: A randomized, controlled trial in palliative care and bereavement. American Journal of Psychiatry, 163, 1208-1218. doi: 10.1176/ajp.2006.163.7.1208Google Scholar
  72. Kleinman, A. (2009). Caregiving: The odyssey of becoming more human. The Lancet, 373, 292-293.
  73. Knapp, C. (2009). Research in pediatric palliative care: Closing the gap between what is and is not known. American Journal of Hospice and Palliative Care, 26, 392–398.
  74. Kristjanson, L. J., & Aoun, S. (2004). Palliative care for families: Remembering the hidden patients. Canadian Journal of Psychiatry, 49, 359–365.
  75. Kuijer, R., Bunk, B., Jong, G., Ybema, J., & Sanderman, R. (2004). Effects of a brief intervention program for patients with cancer and their partners on feeling of inequity, relationship quality and psychological distress. Psycho-Oncology, 13, 321–334.
  76. Kumar, S., D’souza, M., & Sisodia, V. (2013). Healthcare professionals’ fear of death and dying: Implications for palliative care. Indian Journal of Palliative Care, 19, 196–198.
  77. Kwak, J., Salmon, J. R., Acquaviva, K. D., Brandt, K., & Egan, K. A. (2007). Benefits of training family caregivers on experiences of closure during end-of-life care. Journal of Pain and Symptom Management, 33, 434–445. CrossRefPubMedGoogle Scholar
  78. Laguna, J., Goldstein, R., Allen, J., Braun, W., Enguidanos, W., & Enguidanos, S. (2012). Inpatient palliative care and pain: Pre- and post-outcomes. Journal of Pain and Symptom Management, 43, 1051–1059.
  79. Lobb, E. A., Lacey, J., Kearsley, J., Liauw, W., White, L., & Hosie, A. (2013). Living with advanced cancer and an uncertain disease trajectory: An emerging patient population in palliative care? BMJ Supportive & Palliative Care, 5, 352–357.
  80. Lo, C., Hales, S., Jung, J., Chiu, A., Panday, T., Rydall, A., … Rodin, G. (2014). Managing cancers and living meaningfully (CALM): Phase 2 trial of a brief individual psychotherapy for patients with advanced cancer. Palliative Medicine, 28, 234–242.
  81. López-Sierra, H. E., & Rodríguez-Sánchez, J. (2015). The supportive roles of religion and spirituality in end-of-life and palliative care of patients with cancer in a culturally diverse context. Current Opinion in Supportive and Palliative Care, 9, 87–95.
  82. Lowey, S. E., Norton, S. A., Quinn, J. R., & Quill, T. E. (2013). Living with advanced heart failure or COPD: Experiences and goals of individuals nearing the end-of-life. Research in Nursing & Health, 36, 349–358. CrossRefGoogle Scholar
  83. Lupu, D. (2010). American academy of hospice and palliative medicine workforce task force. Estimate of current hospice and palliative medicine physician workforce shortage. Journal of Pain and Symptom Management, 40, 899–911.
  84. Manne, S., Babb, J., Pinover, W., Horwitz, E., & Ebbert, J. (2004). Psychoeducational group intervention for wives of men with prostrate cancer. Psycho-Oncology, 13, 37–46.
  85. Martínez, M., Arantzamendi, M., Belar, A., Carrasco, J. M., Carvajal, A., Rullán, M., & Centeno, C. (2016). Dignity Therapy: A promising intervention in palliative care. Palliative Medicine, 31, 492–509.
  86. McDaniel, S. H., Hepworth, J., & Doherty, W. J. (1992). Medical family therapy: A biopsychosocial approach to families with health problems. New Yorkm NY: Basic Books.Google Scholar
  87. *McDaniel, S., Doherty, W., & Hepworth, J. (2014). Medical family therapy and integrated care (2nd ed.). Washington, DC: American Psychological Association.Google Scholar
  88. McGoldrick, M., & Gerson, R. (1985). Genograms in family assessment. New York, NY: Norton.Google Scholar
  89. McLean, L. M., Walton, T., Rodin, G., Esplen, M. J., & Jones, J. M. (2013). A couple-based intervention for patients and caregivers facing end-stage cancer: outcomes of a randomized controlled trial. Psycho-Oncology, 22, 28–38. CrossRefPubMedGoogle Scholar
  90. Meier, D., & Beresford, L. (2007). Pediatric palliative care offers opportunities for collaboration. Journal of Palliative Medicine, 10, 284–289.
  91. Meier, D. E., Back, A. L., & Morrison, R. S. (2001). The inner life of physicians and care of the seriously ill. JAMA, 286, 3007–3014. CrossRefPubMedGoogle Scholar
  92. Meier, D. E. (2011). Increased access to palliative care and hospice services: Opportunities to improve value in health care. Milbank Quarterly, 89, 343–380.
  93. Mendenhall, T. (2006). Trauma-response teams: Inherent challenges and practical strategies in interdisciplinary fieldwork. Families, Systems & Health, 24, 357–362. CrossRefGoogle Scholar
  94. Mendenhall, T. J., & Trudeau-Hern, S. (2013). Developing self-awareness in clinicians who work in medical settings: A guide for using medical genograms in supervision. In R. Bean, S. Davis, and M. Davey (Eds.), Clinical activities for increasing competence and self-awareness (pp. 141–148). Thousand Oaks, CA: Sage.Google Scholar
  95. Milberg, A., Olsson, E. C., Jakobsson, M., Olsson, M., & Friedrichsen, M. (2008). Family members’ perceived needs for bereavement follow-up. Journal of Pain and Symptom Management, 35, 58–69. CrossRefPubMedGoogle Scholar
  96. Mitschke, D. B. (2008). Cancer in the family: Review of the psychosocial perspectives of patients and family members. Journal of Family Social Work, 11, 166–184. CrossRefGoogle Scholar
  97. Murray, S. A., Kendall, M., Boyd, K., & Sheikh, A. (2005). Illness trajectories and palliative care. BMJ, 330, 1007–1011.
  98. National Coalition for Hospice and Palliative Care. (2013). Clinical practice guidelines for quality Palliative care (3rd ed.). Retrieved from
  99. National Consensus Project for Quality Palliative Care. (2013). Clinical practice guidelines for quality palliative care (3rd ed.). Pittsburgh, PA: Author.Google Scholar
  100. National Quality Forum (NQF). (2006). A national framework and preferred practices for palliative and hospice care quality. Retrieved from
  101. Negash, S., & Sahin, S. (2011). Compassion fatigue in marriage and family therapy: Implications for therapists and clients. Journal of Marital and Family Therapy, 37, 1–13. CrossRefPubMedGoogle Scholar
  102. National Hospice and Palliative Care Organization. (2015). NHPCO’s facts and figures: Pediatric palliative and hospice care in America. Retrieved from
  103. Northouse, L., Katapodi, M., Song, L., Zhang, L., & Mood, D. (2010). Interventions with family caregivers of cancer patients: Meta-analysis of randomized trials. CA: A Cancer Journal for Clinicians, 60, 317–339.
  104. Obermeyer, D., Makar, M., Abujaber, S., Dominici, F., Block, S., & Cutler, D. M. (2014). Associations between the Medicare hospice benefit and health care utilization and costs for patients with poor-prognosis cancer. JAMA, 312, 1888–1896.
  105. Oishi, A., & Murtagh, F. E. (2014). The challenges of uncertainty and interprofessional collaboration in palliative care for non-cancer patients in the community: A systematic review of views from patients, carers and health-care professionals. Palliative Medicine, 28, 1081–1098.
  106. Patterson, J., Peek, C. J., Heinrich, R. L., Bischoff, R. J., & Scherger, J. (2002). Mental health professionals in medical settings: A primer. New York, NY: Norton.Google Scholar
  107. Peek, C. J., & Heinrich, R. L. (2000). Integrating behavioral health and primary care. In M. Maruish (Ed.), Handbook of psychological assessment in primary care settings. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  108. Persson, C., Ostlund, U., Wennman-Larsen, A., Wengstrom, Y., & Gustavsson, P. (2008). Health-related quality of life in significant others of patients dying from lung cancer. Palliative Medicine, 22, 239–247. CrossRefPubMedGoogle Scholar
  109. Peterman, A. H., Fitchett, G., Brady, M. J., Hernandez, L., & Cella, D. (2002). Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy—Spiritual Well-being Scale (FACIT-Sp). Annals of Behavioral Medicine, 24, 49–58. CrossRefPubMedGoogle Scholar
  110. Piercy, K., & Chapman, J. (2001). Adopting the caregiver role: A family legacy. Family Relations, 50, 386–393.
  111. Polst Organization. (2016). About the national Polst program. Retrieved from
  112. Pratt, M., & Wood, M. (Eds.). (2015). Art therapy in palliative care: The creative response. New York, NY: Routledge.Google Scholar
  113. Prince-Paul, M. (2008). Understanding the meaning of social well being at the end-of-life. Oncology Nursing Forum, 35, 365–371. CrossRefPubMedGoogle Scholar
  114. Puchalski, C. (2006). Spirituality and medicine: Curricula in medical education. Journal of Cancer Education, 21, 14–18. Retrieved from CrossRefPubMedGoogle Scholar
  115. Rayner, L., Loge, J. H., Wasteson, E., & Higgson, I. J. (2009). The detection of depression in palliative care. Current Opinion Supportive Palliative Care, 3, 55–60.
  116. Renzaho, A., Romios, P., Crock, C., & Sonderlund, A. (2013). The effectiveness of cultural competence programs in ethnic minority patient-centered health care: A systematic review of the literature. International Journal for Quality in Health Care, 25, 261–269. doi:  10.1093/intqhc/mzt006
  117. Richardson, P. (2014). Spirituality, religion and palliative care. Annals of Palliative Medicine, 3, 150–159.
  118. *Rolland, J. S. (2005). Cancer and the family: An integrative model. Cancer, 104, 2584–2595.
  119. *Rolland, J. S. (1994). Families, illness, and disability: An integrative treatment model. New York, NY: Basic Books.Google Scholar
  120. Rushton, C. (2004). Integrating ethics and palliative care in pediatrics. American Journal of Nursing, 104, 54–63.
  121. Sanchez-Reilly, S., Morrison, L., Carey, E., Bernacki, R., O’neill, L., Kapo, J., … deLima Thomas, J. (2013). Caring for oneself to care for others: Physicians and their self-care. Journal of Supportive Oncology, 11, 75–81.  10.12788/j.suponc.0003 CrossRefPubMedPubMedCentralGoogle Scholar
  122. Schmitt, F., Santalahti, P., & Saarelainen, S. (2008). Cancer families with children: Factors associated with family functioning: A comparative study in Finland. Psycho-Oncology, 17, 363–372.
  123. Seibaek, L., Lise, H., & Niels, C. H. (2013). Secular, spiritual, and religious existential concerns of women with ovarian cancer during final diagnostics and start of treatment. Evidenced Based Complementary Alternative Medicine, 2013, 1–11.
  124. Selecky, P. A., Eliasson, C. A., Hall, R. I., Schneider, R. F., Varkey, B., & McCaffree, D. R. (2005). Palliative and end-of-life care for patients with cardiopulmonary diseases: American College of Chest Physicians position statement. Chest, 128, 3599–3610. CrossRefPubMedGoogle Scholar
  125. Selman, L., Beynon, T., Higginson, I. J., & Harding, R. (2007). Psychological, social and spiritual distress at the end-of-life in heart failure patients. Current Opinion Supportive Palliative Care, 1, 260–266. CrossRefGoogle Scholar
  126. Shore, J. C., Gelber, M. W., Koch, L. M., & Sower, E. (2016). Anticipatory grief. Journal of Hospice & Palliative Nursing, 18, 15–19. CrossRefGoogle Scholar
  127. Sidebottom, A. C., Jorgenson, A., Richards, H., Kirven, J., & Sillah, A. (2015). Inpatient palliative care for patients with acute heart failure: Outcomes from a randomized trial. Journal of Palliative Medicine, 18, 134–142.
  128. Simon, J. L. (2008). Anticipatory grief: Recognition and coping. Journal of Palliative Medicine, 11, 1280–1281. CrossRefPubMedGoogle Scholar
  129. Sulmasy, D. P. (2002). A biopsychosocial-spiritual model for the care of patients at the end-of-life. The Gerontologist, 42(Suppl. 3), 24–33. CrossRefPubMedGoogle Scholar
  130. Thompson, V. L. S., Bugbee, A., Meriac, J. P., & Harris, J. K. (2013). The utility of cancer-related cultural constructs to understand colorectal cancer screening among African Americans. Journal of Public Health Research, 2, e11–e18. CrossRefPubMedPubMedCentralGoogle Scholar
  131. Traa, M. J., De Vries, J., Bodenmann, G., & Den Oudsten, B. L. (2015). Dyadic coping and relationship functioning in couples coping with cancer: A systematic review. British Journal of Health Psychology, 20, 85–114. CrossRefPubMedGoogle Scholar
  132. Trudeau-Hern, S., & Daneshpour, M. (2012). Cancer’s impact on spousal caregiver health: A qualitative analysis in grounded theory. Contemporary Family Therapy, 34, 534–554. CrossRefGoogle Scholar
  133. Ussher, J., Kirsten, L., Butow, P., & Sandoval, M. (2006). What do cancer support groups provide which other supportive relationships do not? The experience of peer support groups for people with cancer. Social Science & Medicine, 62, 2565–2576. CrossRefGoogle Scholar
  134. Waldrop, D. P., & Meeker, M. A. (2012). Communication and advanced care planning in palliative and end-of-life care. Nursing Outlook, 60, 365–369.
  135. Weis, J. (2003). Support groups for cancer patients. Supportive Care in Cancer, 11, 763–768. CrossRefPubMedGoogle Scholar
  136. White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York, NY: W. W. Norton & Company.Google Scholar
  137. World Health Organization. (2013). Essential medicines in palliative care. Retrieved from
  138. Wilkie, D. J., & Ezenwa, M. O. (2012). Pain and symptom management in palliative care and at end-of-life. Nursing Outlook, 60, 357–364.
  139. Williams-Reade, J., Freitas, C., & Lawson, L. A. (2014). Narrative-informed medical family therapy: Using narrative therapy practices in brief medical encounters. Families, Systems, and Health, 32, 416–425. CrossRefPubMedGoogle Scholar
  140. Williams-Reade, J., Lamson, A., White, M. B., Knight, S., Ballard, S., & Desai, P. (2015). Paediatric palliative care: A review of needs, obstacles, and the future. Journal of Nursing Management, 23, 4–14.
  141. *Wright, L., Watson, W., & Bell, J. (1996). Beliefs: The heart of healing in families and illness. New York, NY: Basic Books.Google Scholar
  142. Wright, L. M. (2009). Spirituality, suffering and beliefs: The soul of healing with families. In F. Walsh (Ed.), Spiritual resources in family therapy (2nd ed., pp. 65–80). New York, NY: Guilford Press.Google Scholar
  143. Wynne, L., Shields, C., & Sirkin, M. (1992). Illness, family theory, and family therapy: Conceptual issues. Family Process, 31, 3–18.
  144. Zambroski, C. H. (2006). Managing beyond an uncertain illness trajectory: Palliative care in advanced heart failure. International Journal of Palliative Nursing, 12, 566–573.  10.12968/ijpn.2006.12.12.22543

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Behavioral Health, Loma Linda UniversityLoma LindaUSA
  2. 2.Department of Family Social ScienceUniversity of MinnesotaSaint PaulUSA

Personalised recommendations