Among all cancer patients in the palliative phase, ¾ have reached the age of 65. An aging population will increase the number of people afflicted with cancer, and create challenges for patients, family members and health services. Nevertheless, limited research has focused explicitly on the experiences and needs of older cancer patients in the palliative phase and their families. Therefore, the aim of this study is to explore what older home dwelling cancer patients in the palliative phase and their close family members, as individuals and as a family, experience as important and difficult when facing the health services. We used a qualitative descriptive design. Data was collected through family group interviews with 26 families. Each interview consisted of an older home dwelling cancer patient and one to four family members with different relationships to the patient (e.g. spouse, adult children and/or children-in-law). Data was analysed by qualitative content analysis. The main theme is “Non-palliative care” – health care services in the palliative phase not tailored to family needs. Three themes are revealed: 1) exhausting cancer follow-up, 2) a cry for family involvement, and 3) fragmented care. The health services seem poorly organised for meeting the demands of palliative care for older home dwelling cancer patients in the palliative phase and their family members. Close family members would like to contribute but health services lack systems for involving them in the follow-up of the patient.

This study explores experiences of elderly patients with cancer and their family members with regard to what is important and difficult in the family relationships during the palliative phase. Family group interviews were conducted with 26 families. The data were analyzed using qualitative content analysis. Three themes emerged: "Ensuring a positive final time together," "Avoiding tension and conflict," and "Concealing thoughts, feelings, and needs." The main theme, "A valuable but demanding time," indicates that although families find this phase of life challenging, they emphasize the importance of ensuring that this time is spent together in a positive way as a family.

Objective: Studies focusing on the impact of caregiving for older adult home-dwelling patients with cancer in the palliative phase, particularly the burdens on different family caregiver groups, are limited. The objective of this study was to assess and compare caregiver reactions and social provisions among different family caregiver groups in Norway.Methods: The sample consisted of 58 family members caring for 26 home-dwelling older adult patients with advanced cancer. The Caregiver Reaction Assessment and Social Provisions Scale were used to assess the caregiver reactions and social support, respectively. The analyses were performed using descriptive statistics.Results: Significant differences were revealed between the family caregiver groups in the following three dimensions of the Caregiver Reaction Assessment: impact on schedule, lack of family support and impact on health. Significant differences were revealed between the family caregiver groups in the following two dimensions of the Social Provisions Scale: nurturance and attachment.Conclusions: In our study, children and children-in-law caring for widowed patients and spouses were the most vulnerable family caregivers. We recommend assessing the caregiver situation of all available family members caring for older adult patients with advanced cancer to identify the most vulnerable caregivers.