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Physicians can help family members caring for dying loved ones

Physicians have five areas of opportunity to be of service to family members caring for patients at the end of life, according to a UCSF Medical Center palliative care expert.

The recommendations appear in the January 28, 2004 issue of the Journal of the American Medical Association (JAMA), in a section titled Perspectives on Care at the Close of Life, co-edited by UCSF clinician/researchers.

These interventions include promoting good communication with family members, encouraging appropriate advance care planning and decision-making, supporting home care, demonstrating empathy for family emotions and relationships, and attending to family grief and bereavement.

"In caring well for family caregivers at the end of life, physicians may not only improve the experiences of patients and family, but also find greater sustenance and meaning in their own work," said Michael Rabow, MD, an internal medicine and palliative care specialist at UCSF Medical Center. Rabow is the lead author of the new evidence-based discussion of a challenging palliative care case, titled Supporting Family Caregivers at the End of Life: They Don't Know What They Don't Know.

He explained that death in the United States is increasingly preceded by informal support and lay medical care provided by family members, partners and friends.

"About one quarter of adults in the United States report providing informal caregiving, including helping with transportation, shopping, house work, emotional support, nutritional care, personal care and financial management," he said.

"Because this trend is likely to continue because of the aging United States population and the increasing number of diseases managed over many years in outpatient settings, physicians need specific training in how to assist families with end-of-life care."

Given the documented financial, emotional and physical costs of family care giving, including increased mortality for caregivers
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Contact: Maureen McInaney
mmcinaney@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco
27-Jan-2004


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