Abstract
In the bone marrow transplant population, both patients and their families have significant palliative care needs but tend to be underserved by palliative care. The focus of care is curative, and referrals to the palliative care team come late if at all. Symptom burden can be great, and family caregiver burden overwhelming. Many patients will develop acute and/or chronic complications associated with the transplant, some resulting in death. In addition, bone marrow transplant patients are being discharged home while still requiring a significant amount of both physical and psychological care. Family caregivers are expected to provide much of this care often with little support. The result may be fatigue and physical exhaustion, sleeplessness, deterioration in health, and social isolation. In both palliative and hospice care, the patient and family are approached as a single unit, recognizing the strengths and addressing the needs of both parties to affect the overall well-being of the family unit. This article discusses caregiver burden in the bone marrow transplant population throughout the disease trajectory illustrated through the use of a case example. An approach to address the palliative care needs of the family caregiver is outlined.