Quality of life across age and family stage.

It is clear that the quality of life of the individual is intertwined with that of his or her family. Therefore, health care professionals and other professionals who work with families facing terminal illness must (1) identify those factors that put the patient and the family at risk of suffering further disruption of psychosocial quality of life and (2) seek out whatever resources are necessary to help the patient and the family improve their quality of life. Families with young children are more dependent on external resources than are other families, and they place more strains on the spouse caregiver. If these resources are not available, parents are less able to handle crucial developmental family matters. Clinicians who are aware of this deficit are better able to recognize role performance problems and help families obtain the external resources. Secondly, families who have relied on ascribed roles before the parent fell ill are at greater risk of psychosocial dysfunction: they lack appropriate ways to deal with role reallocation in order to make the best use of their talents. Professionals who are sensitive to this can help families adapt to role changes. A third area that places families at risk is poor spousal communication. Good communication patterns appear to facilitate adjustment to both terminal illness and bereavement (4,6). Professionals trained in family and social therapy are equipped to help family members develop effective communication, which can in turn help them prioritize tasks, seek outside resources when needed, and negotiate role assignments.