A Community Approach to Coping

A recent survey by researchers from the University of Montana in Missoula asked cancer patients and their families what medical and social services were important to them as part of the overall caregiving process, including how family members coped with illness, anxiety, dying and grief.

Their objective was to take these individual experiences and develop broad programs that could benefit everyone within the community as they undergo similar life challenges.

Writing in the Journal of Pain and Symptom Management, Dr. Ira Byock and colleagues found that developing such a community-wide approach to issues surrounding cancer care would provide a much-needed guidepost for many families who all-too-often cannot cope with illness and death in an effective way.

Byock's team found that the patients and families in their survey had a wide range of expectations when it came to issues surrounding cancer care, especially at the end of life. For example, there was considerable variation in the use-or non-use-of advance directives. Incorporating a wide range of input, the researchers developed a standard form called "My Choices" that could be used by all families throughout the community.

They similarly developed standard educational programs and recommendations for family caregiving, measuring pain, continuing a dialogue with the healthcare team, practical tools for patient support, and suggestions regarding hospice care.

Byock stressed that a family's caregiving burden can be dramatically eased by looking beyond their individual circumstances and drawing upon the experiences of others. Similar illnesses and caregiving issues have inevitably taken place within other families of the community, they emphasized. Therefore, drawing upon these experiences-and pulling together programs and ideas that seem to have worked for others-can benefit everyone.

They added that while their guidelines were based on the experiences of people in Missoula, their concepts could easily be adapted and extended to communities nationwide.

SOURCE:

Journal of Pain and Symptom Management, September 2001; 22(3): 759-772

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