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Mission Hospice Society Volunteer Training, Levels 1 & 2
IMPACT OF TERMINAL ILLNESS ON FAMILIES
Life-threatening illness affects not only the person who is dying, but also the entire family
system including members inside and outside the home. The prospect of death and the loss
of a family member place the family in a state of unbalance or chaos.
During the period of serious illness, the family can be as deeply disturbed and upset as the
dying person. Among the most difficult tasks faced by the family is that of dealing with
their own emotions. No family that has lived with a terminal illness can survive unchanged
by the ordeal. However, the changes that result are distinct for each family system.
Some families may actually pull together and function better while others may break apart
and never recover “normal” functioning again. It is not unusual for unresolved conflicts and
resentments to surface when people are placed in the stressful situation of watching a loved
one die.
The way in which families cope with a serious illness depends upon several factors:
1. past experiences (people tend to rely on ingrained coping strategies),
2. the dying person’s role in the family (coping may differ depending upon the person’s
contribution to the family system, i.e., wage earner, primary homemaker, etc.),
3. the length of the illness (prolonged illness can be emotionally and financially taxing),
4. the presence of social supports,
5. cultural differences (culture can affect the type of emotion expressed, verbal
communication and willingness to accept outside help),
6. age of patient, young/old
7. quality of marriage and family relationship.
Just as a terminally ill person progresses from a state of health to sickness, to dying; a family
also progresses through various stages. It is important, however, to recognize that each family
is unique and will respond to illness and eventual death in their own way.
According to Elliot Rosen (1990), the family progresses through three main phases:
(1) The First Phase – Initial Diagnosis
During the first phase of initial symptoms, diagnosis, prognosis and treatment, the family’s first
reactions are fear and denial.
As the family begins acknowledging the prospect of loss, anxiety and anger may surface. This
can result in a process of “scapegoat’ or trying to put the blame on someone for the fate they