Webster’s dictionary defines family as a group of people united by certain convictions or a common affiliation. The patient, their illness and death are the common affiliation which brings people together. The patient may include friends, fellow church members, ex-spouces and others in their concept of family. Hospice caregivers must be able to recognize the value of each individual and be willing to meet their needs.

Role Changes. Role changes occur in a household when a terminal illness is diagnosed. If a husband is diagnosed with a terminal illness, the wife may be suddenly faced with a loss of security, her end of dependence on her husband and she sees loneliness ahead of her. She must also take on her husband’s responsibilities, which may include finances, tending to the care of the lawn; things which may never have been the wife’s concern.

On the other hand, a husband whose wife has been diagnosed as terminally ill may have a more difficult time in tending to household or childhood activities. Men are traditionally less flexible or less used to dealing with these matters. There may also be changes for an adult child when their parent is diagnosed. The previously dependent child must now be the “parent” or the one who must look after their mother or father as a “child.”

Changes in family members will directly affect the patient. If the household becomes totally disrupted or the caregivers are unable to effectively cope with their new roles, the patient may feel guilt or remorse at causing trouble.

Family members cannot expect one member to be a constant presence for the terminally ill. Each member needs time out in order to recharge their batteries.

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