Couples facing death. I-Psychosocial aspects.

Forty-one couples facing the prospect of separation by death were followed up from the time of admission to a continuing care unit through death of the patient to an interview with the bereaved spouse. Half the patients were found to have anxiety or depression or both, usually as a result of failure to cope with specific difficulties. These fell into four groups: unsatisfactory communication, direct effects of illness and treatment, failure to adjust lifestyles to changing circumstances, and pre-existing marital and family problems. This paper examines in detail the problems in the second and third groups. Support was offered to the patient and family in an attempt to help them to adjust and make the best use of their resources. The responses obtained suggest that some of the suffering of terminal illness can be relieved when psychosocial problems are recognised and appropriated help is given.