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Scott Murray's interesting results underline the importance of paying
appropriate attention to the psychosocial-spiritual needs of the patient's
family care givers. His paper highlights the relevance of re-assessment at
key moments in the patient's journey and, in particular, the moment when
the patient returns home. Fig 2 indicates an increase in psychological and
spiritual distress at this point which primary care and home care teams
need to anticipate and address as necessary. The need for frequent re-
assessment of non-physical needs is not new (NICE 2004) but the reminder
to be proactive in offering support to family carers at critical points is
NICE (2004) Improving Supportive and Palliative Care for Adults with