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Activity Details
  • Credit Amounts:
    • CME: 1.25
    • CPE: 1.25
    • CNE: 1.00
    • CHES: 1.00
  • Cost: Free
  • Release: May 27, 2015
  • Expires: May 26, 2018
  • Estimated Time to Complete:
    1 Hour(s)  15 Minutes
  • System Requirements:
  • Average User Rating:
    (4 Ratings)


Joy Goldsmith Joy Goldsmith, PhD
Associate Professor
Department of Communication Studies
Young Harris College
Young Harris, Georgia

Sandra Ragan Sandra Ragan, PhD
Professor Emerita
Department of Communication
University of Oklahoma
Norman, Oklahoma

Elaine Wittenberg-Lyles Elaine Wittenberg-Lyles, PhD
Associate Professor
Markey Cancer Center and Department of Communication
College of Communication and Information
University of Kentucky
Lexington, Kentucky

Needs Statement

Not only do national health care organizations recommend that a companion/family member accompany consultations to discuss serious diagnosis and treatment plans, but research shows that clinicians provide more information when the patient is accompanied by a family member/companion (Eggly, et al., 2006; Gordon, Street, Sharf, & al, 2006).

In palliative care, family members are the second order patient---they are the unit of care. The family must be welcomed, included and listened to as vital players in the care of the patient (Wittenberg-Lyles, Goldsmith, Sanchez-Reilly, & Ragan, 2008).

The family/caregiver will be carrying primary responsibility for the execution of patient care and must be honored as a partner in caretaking during medical encounters. The caregiver(s) is central to the relationship with the clinician(s), and they have a need and desire to be seen as valuable to the illness journey.

Family members should engage in family meetings with the clinical team to establish the goals of care, plan care logistics, and set realistic expectations for family members about the patient’s condition (Hudson, Thomas, Quinn, & Aranda, 2009). Family meetings, an essential component of palliative care, can help clarify goals of care for patient, family and care team. Some research on family meetings finds that patient involvement in these gatherings is very high, and that the expression of emotional distress over illness and course of care are the most common occurrences---allowing an opportunity for patient and family to process vital relational issues before death. Moreover, terminally ill patients desire to be surrounded by family to help ensure "a good death," and family members desire supportive relationships with providers to ensure a higher quality of care for their loved one. Miscommunication and mistrust can also be diminished when clinicians establish positive relationships with family members before and after a terminal diagnosis (Munn, et al., 2008).

However, to successfully integrate family member into the "treatment team", clinicians must understand the dynamics and variability among families and their communication strategies. The family narrative in the clinical setting can be a rich source of information and relationship-building for the clinician/team/patient/family. Instead of putting aside the ideas and contributions of the caregiver, their stories reveal content-ordering (how information, experience, and lived meanings are organized), and most powerfully in the context of life-limiting illness, they reveal task-ordering (how the family has taken on specialized caregiving tasks required to survive the environment of illness) (Langellier & Peterson, 2006).


Eggly, S., Penner, L. A., Greene, M., Harper, F. W., Ruckdeschel, J. C., & Albrecht, T. L. (2006). Information seeking during "bad news" oncology interactions: Question asking by patients and their companions. Soc Sci Med, 63(11), 2974-2985.

Gordon, H., Street, R., Sharf, B., & al, e. (2006). Racial differences in doctors' information-giving and patients' participation. Cancer, 107(6), 1313-1320.

Hudson, P., Thomas, T., Quinn, K., & Aranda, S. (2009). Family meetings in palliative care: are they effective? Palliat Med, 23(2), 150-157.

Langellier, K., & Peterson, E. (2006). Narrative performance theory: Telling stories, doing family. In D. Braithewaite & L. Baxter (Eds.), Engaging theories in family communication: Multiple perspectives. Thousand Oaks: CA: Sage.

Munn, J. C., Dobbs, D., Meier, A., Williams, C. S., Biola, H., & Zimmerman, S. (2008). The end-of-life experience in long-term care: five themes identified from focus groups with residents, family members, and staff. Gerontologist, 48(4), 485-494.

Wittenberg-Lyles, E., Goldsmith, J., Sanchez-Reilly, S., & Ragan, S. L. (2008). Communicating a terminal prognosis in a palliative care setting: deficiencies in current communication training protocols. Soc Sci Med, 66(11), 2356-2365.

Target Audience

All health professionals, especially those who practice entirely or in part within teams who treat patients in the context of palliative care.


Upon completion of this activity, participants will be able to:

  1. Recognize family member status as second-order patients
  2. Define the family as an open or closed system
  3. Describe a typology of family caregivers from a communication perspective
  4. Identify two communication skills that could be used with family caregivers



The University of Kentucky College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Kentucky College of Medicine designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The University of Kentucky College of Medicine presents this activity for educational purposes only. Participants are expected to utilize their own expertise and judgment while engaged in the practice of medicine. The content of the presentations is provided solely by presenters who have been selected for presentations because of recognized expertise in their field.

ACGME Competencies

  • Interpersonal and communication skills
  • Professionalism

ACPEThe University of Kentucky College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

This knowledge-based activity has been assigned UAN 0022-9999-15-073-H04-P and will award 1.25 contact hours (0.125 CEUs) of continuing pharmacy education credit in states that recognize ACPE providers.

Statements of participation will indicate hours and CEUs based on participation and will be issued online at the conclusion of the activity. Successful completion includes completing the activity, its accompanying evaluation and/or posttest (score 70% or higher) and requesting credit online at the conclusion of the activity. Credit will be uploaded to CPE Monitor, and participants may print a statement of credit or transcript from their NABP e-profile. The College complies with the Accreditation Standards for Continuing Pharmacy Education.

The University of Kentucky, College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC).

This educational activity is offered for a maximum of 1.00 ANCC contact hour.

The Kentucky Board of Nursing (KBN) approves The University of Kentucky, College of Nursing (UKCON) as a provider as well. ANCC and KBN approval of a continuing nursing education provider does not constitute endorsement of program content nor commercial sponsors. The University of Kentucky does not approve commercial products. This educational activity is offered for a maximum of 1.2 KBN contact hours.

Provider #: 3-0008-01-13-389. In order to receive credit, participants complete this CNE activity and submit a credit application and evaluation form online. Certificates may be printed once the evaluation is completed.

The Department of Public Health, Western Kentucky University has been designated as a Multiple Event Provider (#KY0022) of Category I continuing education contact hours in health education by the National Commission for Health Education Credentialing, Inc. This program has been reviewed and approved for up to 1.00 Category I entry level contact hour in health education for event #61027.

Faculty Disclosure

No speakers, authors, planners, reviewers or staff members have any relevant financial relationships to disclose. No other speakers or authors will discuss off-label use of a product.

Content review confirmed that the content was developed in a fair, balanced manner free from commercial bias. Disclosure of a relationship is not intended to suggest or condone commercial bias in any presentation, but it is made to provide participants with information that might be of potential importance to their evaluation of a presentation.


In collaboration with UK College of Nursing Continuing Education Office and UK Center for Interprofessional Health Education.

CE Content Concerns


Concerns or complaints related to ACPE or ACCME standards may be submitted in writing to the Director of UK HealthCare CECentral by fax to 859-323-2920, or by mail to 2365 Harrodsburg Road, Ste B475, Lexington, KY 40504


  • The Director or his/her designee will review, investigate, forward and/or respond to complaints and will put forth a best effort to adjudicate the issue(s), along with CECentral staff members, within two (2) weeks of receipt of the grievance or complaint.
  • If needed, concerns, complaints, or grievances will be brought before the UK HealthCare CECentral Advisory Board.
  • Issues regarding activity content also will be reviewed and addressed by the Activity Director.
  • A written decision will be issued in a timely manner by the Director of UK HealthCare CECentral or his/herdesignee.
  • Grievances will be considered when planning future activities.

Appeal Procedure

  • Persons who wish to appeal a decision should address the appeal by email, fax or in writing to the Director of UK HealthCare CECentral within two (2) weeks of receipt of the response.
  • The Director will bring the appeal to the UK HealthCare CECentral Advisory Board.
  • The results of the appeal will be sent to the participant no later than two (2) weeks following the meeting of the board.