What does it mean to be ‘present and accounted for’ when a family member is facing chronic illness or death? How does one define a self in relation to the ill or dying member and the family? Rooted in Murray Bowen’s family systems theory, this edited volume provides conceptual ideas and applications useful to clinicians who work with families facing chronic illness or the death of a member. The text is divided into four parts: Part I provides a detailed overview of Bowen’s theory perspectives on chronic illness and death and includes Murray Bowen’s seminal essay "Family Reaction to Death." In Parts II and III, chapter authors draw upon Bowen theory to intimately explore their families' reactions to and experiences with death and chronic illness. The final part uses case studies from contributors’ clinical practices to aid therapists in using Bowen systems perspectives in their work with clients. The chapters in this volume provide a rich and broad range of clinical application and personal experience by professionals who have substantial knowledge of and training in Bowen theory. Death and Chronic Illness in the Family is an essential resource for those interested in understanding the impact of death and loss in their professional work and in their personal lives.

Move through emotional triangles toward a natural systems view of the individual in the context of the family and society Triangles: Bowen Family Systems Theory Perspectives presents clear applications of Murray Bowen’s concept of the emotional triangle in the family, the organization, and society. This comprehensive book discusses in detail the theory, the theory’s application to the therapist’s own family, clinical applications, organizational applications, and societal applications. This unique resource examines the value of the triangle concept for understanding the emotional process of the family, the organization, and society. Triangles: Bowen Family Systems Theory Perspectives provides a theoretical context for understanding the triangle concept and its application, then progresses to exploring and applying the concept of the triangle and interlocking triangles to self, family, and other contexts. This book is devoted to explicating Bowen’s seminal concept of the triangle, and providing a clear description of the process of detriangling in clinical practice. The text includes several case studies and vignettes to illustrate concepts. Topics in Triangles: Bowen Family Systems Theory Perspectives include: a historical and conceptual overview the triangle’s function in the effort to increase differentiation of self the presence of triangles in non-human primates Bowen’s differentiation of self effort in his own family and business the functioning of triangles at the time of chronic illness and death emotional triangles involving pets and humans the application of the concept of triangles and interlocking triangles to clinical issues in marriage the presence of triangles in the child-focused family triangles in stepfamilies the triangle’s presence and function in families with substance abusing teens triangles involving extramarital relationships triangles in organizations and businesses the triangle’s function in the context in societal emotional process and much more! Triangles: Bowen Family Systems Theory Perspectives is a stimulating, enlightening resource for family therapists, social workers, psychologists, pastoral counselors, and counselors.

For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

Because chronic disorder is becoming an ordinary feature of family life and development, understanding its impact has become critical. This volume, and the conference proceedings it reports, represents a major effort to examine the family's response to chronic physical or psychopathological illness in one or more of its members. Recent data are revising our notions of chronic illness. Evidence is mounting that chronic psychiatric disorders reflect, in part, abnormalities of brain structure and function. In this sense, they are, in part, medical disorders. On the other hand, a number of traditionally labeled medical disorders produce a broad range of psychological symptoms and are exquisitely sensitive to psychosocial influences. Families undergo a complex process of adaptation during which their response to stress and their fundamental beliefs about learning and parenting change. These beliefs endure and are difficult to alter. By examining the processes in a wide range of chronic conditions, this volume helps to identify the common, underlying processes of adaptation. The first three chapters concern the families' responses to disorders that are distinctly medical; the next three focus on families' responses to "grey zone" disorders or anomalies that appear early in life, minor physical anomalies, and communication handicaps; and one chapter focuses exclusively on schizophrenia. The last chapter reflects an effort to develop a model based on the experience of researchers with both psychiatric and medical illness.

Self-care deficits and a slowly dwindling course to death, which usually results from frailty or dementia. Effective and reliable care for persons coming to the end of life will require changes in the organization and financing of care to match these trajectories, as well as compassionate and skillful clinicians. (Available from the publisher or libraries holding the journal.).

Challenging assumptions about caregiving for those dying of chronic illness. What is it like to live with—and love—someone whose death, while delayed, is nevertheless foretold? In Living in Death’s Shadow, Emily K. Abel, an expert on the history of death and dying, examines memoirs written between 1965 and 2014 by family members of people who died from chronic disease. In earlier eras, death generally occurred quickly from acute illnesses, but as chronic disease became the major cause of mortality, many people continued to live with terminal diagnoses for months and even years. Illuminating the excruciatingly painful experience of coping with a family member’s extended fatal illness, Abel analyzes the political, personal, cultural, and medical dimensions of these struggles. The book focuses on three significant developments that transformed the experiences of those dying and their intimates: the passage of Medicare and Medicaid, the growing use of high-tech treatments at the end of life, and the rise of a movement to humanize the care of dying people. It questions the exalted value placed on acceptance of mortality as well as the notion that it is always better to die at home than in an institution. Ultimately, Living in Death’s Shadow emphasizes the need to shift attention from the drama of death to the entire course of a serious chronic disease. The chapters follow a common narrative of life-threatening disease: learning the diagnosis; deciding whether to enroll in a clinical trial; acknowledging or struggling against the limits of medicine; receiving care at home and in a hospital or nursing home; and obtaining palliative and hospice care. Living in Death’s Shadow is essential reading for everyone seeking to understand what it means to live with someone suffering from a chronic, fatal condition, including cancer, AIDS, Alzheimer’s, and heart disease.

Couples and families face daunting challenges as they cope with serious illness and disability. This book gives clinicians a roadmap for helping affected individuals and their loved ones live well with a wide range of child, adult, and later-life conditions. John S. Rolland describes ways to intervene with emerging challenges over the course of long-term or life-threatening disorders. Using vivid case examples, he illustrates how clinicians can help families harness their strengths for positive adaptation and relational growth. Rolland's integrated systemic approach is useful for preventive screening, consultations, brief counseling, more intensive therapy, and multifamily groups, across health care settings and disciplines. This book significantly advances the clinical utility of Rolland?s earlier landmark volume, Families, Illness, and Disability.

The Handbook of Health Social Work provides a comprehensive and evidence-based overview of contemporary social work practice in health care. Written from a wellness perspective, the chapters cover the spectrum of health social work settings with contributions from a wide range of experts. The resulting resource offers both a foundation for social work practice in health care and a guide for strategy, policy, and program development in proactive and actionable terms. Three sections present the material: The Foundations of Social Work in Health Care provides information that is basic and central to the operations of social workers in health care, including conceptual underpinnings; the development of the profession; the wide array of roles performed by social workers in health care settings; ethical issues and decision - making in a variety of arenas; public health and social work; health policy and social work; and the understanding of community factors in health social work. Health Social Work Practice: A Spectrum of Critical Considerations delves into critical practice issues such as theories of health behavior; assessment; effective communication with both clients and other members of health care teams; intersections between health and mental health; the effects of religion and spirituality on health care; family and health; sexuality in health care; and substance abuse. Health Social Work: Selected Areas of Practice presents a range of examples of social work practice, including settings that involve older adults; nephrology; oncology; chronic diseases such as diabetes, heart disease, and HIV/AIDS; genetics; end of life care; pain management and palliative care; and alternative treatments and traditional healers. The first book of its kind to unite the entire body of health social work knowledge, the Handbook of Health Social Work is a must-read for social work educators, administrators, students, and practitioners.

When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

In the United States, chronic diseases currently account for 70 percent of all deaths, and close to 48 million Americans report a disability related to a chronic condition. Today, about one in four Americans have multiple diseases and the prevalence and burden of chronic disease in the elderly and racial/ethnic minorities are notably disproportionate. Chronic disease has now emerged as a major public health problem and it threatens not only population health, but our social and economic welfare. Living Well with Chronic Disease identifies the population-based public health actions that can help reduce disability and improve functioning and quality of life among individuals who are at risk of developing a chronic disease and those with one or more diseases. The book recommends that all major federally funded programmatic and research initiatives in health include an evaluation on health-related quality of life and functional status. Also, the book recommends increasing support for implementation research on how to disseminate effective longterm lifestyle interventions in community-based settings that improve living well with chronic disease. Living Well with Chronic Disease uses three frameworks and considers diseases such as heart disease and stroke, diabetes, depression, and respiratory problems. The book's recommendations will inform policy makers concerned with health reform in public- and private-sectors and also managers of communitybased and public-health intervention programs, private and public research funders, and patients living with one or more chronic conditions.