This paper offers a stress theory based conceptual framework for understanding proactive options for care-getting for patients living with cancer that is also relevant to patients living with other chronic or life threatening illnesses. Barriers and facilitators to active efforts for obtaining responsive care from both informal and formal sources are discussed. This "Care-Getting" model explores benefits of proactive care-getting for diminishing physical discomfort/suffering, burden of illness and disability, and psychological distress. We highlight unique issues in care-getting that patients face at different stages of the life course. Implications of prior research related to the model for practice and intervention are discussed.
KEY TERMSCare-getting; life course; cancer care; marshalling care; activated patient In this paper, the special needs of patients as care recipients will be highlighted by focusing on challenges of patients facing serious chronic illness, as exemplified by cancer. Such illnessrelated challenges are normative for the very old, but also apply to all individuals who face life-threatening illness throughout the life course. The discussion considers proactive adaptations by patients, throughout the life course, who deal with life threatening illness such as cancer. Care-getting refers to active efforts by patients to obtain responsive care from both informal and formal sources. The former include family and friends, while the latter involve health care professionals. Care-getting is distinct from the commonly studied phenomenon of caregiving that describes provision of assistance, often provided by family members in the context of major illness situations. The timeliness of focusing on care-getting is underscored by the virtual absence of discourse on the challenges of care-getting among the chronically ill, despite extensive focus on issues of caregiving. Accordingly, successful care-getting may be viewed as a critical goal during a disabling illness (Wagner, Austin, Davis, Hindmarsh, Schaefer, & Bonomi, 2001). An understanding of the maintenance of good quality of life among chronically ill patients has been limited by the lack of systematic theoretical attention to caregetting throughout the life course. This paper synthesizes orientations from the fields of sociology, social work, nursing, and psychology to expand conceptual understanding of this critical area. We build on a stress theoretical framework (Pearlin, 1989) to help appreciate the unique challenges faced by chronically ill patients. Mastery of the adaptive tasks of care-getting involves marshalling informal and formal support, which allows for obtaining the best medical