Mel Borins, MD, CCFP, FCFP, Associate Professor, Department of Family & Community Medicine, University of Toronto; Active staff, St. Joseph’s Health Centre
Danny Yeung MD, CCFP, CGPP, Associate Clinical Director, Institute of Family Living and Active Staff, Department of Family and Community Medicine, North York General Hospital; Steering Committee, Collaborative Mental Health Care Network, Ontario College of Family Physicians
Working With Families Institute, Department of Family & Community Medicine, University of Toronto
Posted: July 13, 2014 Format:
Working With Dying Patients and Their Families: A Task-Oriented Approach
The family physician is often involved in the care of patients who are dying. The demands on the family physician often increase after acute care has failed and the person needs palliative care, or when coordinating community resources during therapy, or for pain and symptom management. The complexities of this care are increasing. A task-oriented, interdisciplinary approach will help to ensure a dignified death without unnecessary suffering and help families cope with the loss of a loved one.
In today’s world, families are under increasing stress, from financial and time constraints, to family breakdown, substance abuse, and threats of violence. Family physicians are seeing an increase in psychosocial issues such as anxiety and stress-related disorders, often co-existing with and complicating medical problems such as diabetes or pneumonia. The psychosocial issues are often more difficult to diagnose and manage than are the medical problems—and all take place in the family context. Very often, the family is the key to dealing effectively with the whole spectrum of complaints, requiring a psychosocial assessment. In the crowded family medicine curriculum, this vital area of knowledge and skill is often ignored in favour of more clear-cut procedural skills.
To educate family physicians about dealing with families, a group of family medicine educators, practitioners and mental health professionals affiliated with the Department of Family and Community Medicine at the University Of Toronto founded the Working with Families Institute (WWFI) in 1985. The WWFI has developed various training experiences for trainees and practising physicians.