CASCADE (CAre Supporters Coached to be Adept DEcision partners) for Family Members

Around 20 million American citizens have one or more major problems with a family member each year. This supports that the majority of patients suffering from MDD develop their disorder as a result of negative experiences with family members.

The risk of relatives developing a curable cancer is high for prostate cancer (18%) and breast cancer (11%); however, the risk is very low for ovarian cancer (1%). A risk has been identified for siblings, who, although not diagnosed at the time of diagnosis, did have a two-fold increased risk of dying from a previously diagnosed cancer.

The treatments received by patients differed from those recommended in the guidelines for their family members. Interventions may be needed to assist individuals with family members with complex chronic problems in the context of their social relationships.

The most common sign for family members is change in behavior. Common signs of relatives are memory problems, dizziness and constipation. Other less common signs are muscle atrophy, dizziness or vertigo, hearing problems, change in sleep, dizziness and blurred vision. As individuals ages, they commonly show signs of dementia.

Depression may be caused by many factors, including emotional health, family history, stressful experiences, attitudes and beliefs, and physical health problems. There are currently many research gaps about the causes of depression in family members. At a basic level, family members often have psychological, physical and social health problems but are often not aware of them despite their effect on their mental health. More study is required about this and how to manage and care for family members with depression.

Family members and the whole family contribute to the well being and coping of everyone affected by rheumatoid arthritis and are both important sources and recipients of information, support, care and treatment. It is especially important for patients, and for health care professionals who provide information, support, treatment and rehabilitation, to inform and educate family members of their role and part in the care process.

More research is needed to determine the effectiveness of cascade in the therapeutic use scenario. To date, there is insufficient empirical evidence to support use of cascade for therapeutic interventions.

Given that a quarter of cancer patients want their family members to know about clinical trials, and the fact that over one-third of people with solid cancer, especially those living with solid tumors, and over 70% of people with solid cancers who are already receiving treatment would like clinical trials for them, it would make sense to try to recruit family members of cancer patients in clinical trials. There are various ways to approach this, and it should be discussed with family members. At the very least, clinicians who intend to enroll patients in clinical trials of their own should take the initiative to offer these therapies to their patients' family members.

While the primary cause of family members are unknown, a significant percentage of the family members had many risk factors in common. The risk factors for familial PC include a previous history of PC, smoking history, and advanced age. While there is not a single cause for family members with PC, early detection of this disease could result in improved outcomes. The risk factors for family members are also highly relevant for diagnosis and treatment. As well, the risk factors for family members include a family history.\n

Care cascade has been defined as a complex care-giving role, which can be trained in family support groups that focus on care cascade and trained facilitators, most usually from the community, using a process grounded in 'cascade practice' and the carers own experiences. If cascade training can be integrated into the practice supported by the care support team there could be benefits across the family.

Cascade is a well-established approach to enhancing safety and competence for care in hospice and palliative care. In spite of its longstanding popularity and evidence base, researchers and clinicians still have few rigorous studies that seek to evaluate its effectiveness. This issue has led to skepticism about the validity and generalisability of cascade models. Findings from a recent study is important in developing the evidence base to inform policy makers and healthcare providers about what cascade interventions work.