Aims: Consider the implications of assessment and intervention with families involved in end of life care and family functioning. Present key research findings. Present how the integration of research, clinical practice, user perspectives and context works towards seamless family palliative care. Content: Since the early days of the hospice and palliative care movement, practice wisdom has dictated that the family be the unit of palliative care. Custom and practice has, over the decades, re-inforced the emphasis on work with the family prior to the death. Effective work with families involves skilled assessment and intervention. Traditionally in palliative care all members of the multi-professional team work with the family directly or indirectly.
What are the research findings which underpin these practices? How do we know that the emphasis on family work before the death prevents complex bereavement problems afterwards? Which families require most attention? These are some of the questions this paper will attempt to answer.
The paper will endeavour to analyse the various sources of evidence and experience that point the way towards an integrated family palliative care. Research studies will mainly focus on the work of Kissane and draw heavily of family focused grief therapy (Kissane and Block, 2002). Evidence of practice with families will relate to Monroe’s work with families (Monroe, 2003).
The paper will conclude with reminders of the importance of promoting the user/patient perspective as another source of important evidence. Finally, context will be considered as family palliative care services have to be culturally and setting appropriate.