Research of AYAs with cancer has developed significantly over the last 20 years. The research has demonstrated that AYAs with cancer are a forgotten population, who require closer study in order to understand their unique issues. This paper examines family members' experiences of adolescents and young adults (AYAs) during the dying stage of their cancer trajectory. The results are drawn from a larger study titled 'From Go to Woe; Family Members' Stories of Adolescents and Young People Living with and Dying from Cancer, which storied the family members' experience of the diagnosis, treatment, dying and death of an AYA family member, utilizing Armstrong-Coster's (2004) four stages of the cancer trajectory. The principal researcher's motivation to understand and story these experiences was related to her own isolation and lack of information when her 16 year old son Anthony, was diagnosed with and eventually died of cancer at 17 years of age.The significance of this study is the contribution made to the identification of issues that can inform health policy/ guidelines. The findings have the potential to increase understanding of, and prepare family members and AYAs with cancer, for the experience of the death and dying stage of the cancer trajectory.Keywords: Adolescents and young adults; Cancer; Death and dying; End of life decision making
Literature ReviewResearch over the last 20 years has indicated that AYAs with cancer are a forgotten population who require closer study in order to understand their unique problems [1][2][3][4][5][6][7][8][9] prompting Michelagnoli, Pritchard and Phillip [3] to describe this group of people as a lost tribe. One factor identified to account for this disadvantage is the fragmentation of services [1,[10][11][12].The fragmentation of services is a result of AYAs being cared for in two systems of care, the paediatric and the adult [13] with different goals and philosophies of care.The paediatric system has been described as mainly family focused and the adult system disease focused [14].This has implications not only for medical treatment of AYAs with cancer, but also presents problems in providing targeted support services. O'Brien, et al.,[15] identified the following issues that account for the lack of support services.Support services vary across adult hospitals and are fewer than those provided by specialist paediatric hospitals; support services provided both in paediatric or adult hospitals are not designed for the AYA age group, and the lack of critical mass in either system prevents optimal support service. These issues are amplified during the dying stage of the cancer journey.There is limited research on AYAs dying with cancer and their families. A review of literature found only four authors [16][17][18][19]. Wein, Pery and Zer [19] provided information specific to this group and their specific psychosocial needs whilst dying.Bisset et al. [16] identified the following needs for AYAs, their parents and siblings for palliative care services: "involvement in dec...