Dying and death of a family member.

There are many factors that have mitigated against optimal or even adequate medical care of the dying patient despite recent technological advances in medicine. Major changes are now taking place in terms of public expectations, medical practice, and legislation related to dying and death in this society. The dying patient has five basic requirements that must be met: independence, dignity, acceptance by others of an individual approach to dying, relief of symptoms, and physical care. In many instances the home offers advantages over institutional settings if other family members are able to manage the burdens of care. Regardless of setting, the family physician plays a central role in the care of the dying patient and his or her family during preterminal, terminal, and follow-up stages. This paper presents an approach to comprehensive care whereby the symptoms of incurable terminal illness can be effectively relieved on an individualized basis. Anticipatory guidance and care are important for the effects of terminal illness and death of a family member on the surviving family members, particularly with regard to recognition and treatment of depression.