Table 1 Themes of Transitions and Data Examples

Environmental Changes

"She was an outdoor person, so naturally it was a big change, but she did accept it and of course her condition was making her realize that she... couldn't be outdoors." (Family Caregiver) (C-03)

"It just seems like their whole house is turned up topsy turvy as you're bringing in all these supplies..." (Health Care Professional) (HCP-02)

"...being in the hospital, because I was in the hospital... and I can't tell you how astounded I was" (Palliative Patient) (P-03)

Relationships and Roles

"I really just felt like a nurse myself... That, that was how I felt. I mean, I used to work as a nurses aide in a nursing home... and I do have some... you know, knowledge... of that kind of thing... But all of a sudden the relationship of husband/wife was gone and it was nurse and patient for me... That was our, a big change." (Family Caregiver) (C-06)

"...in a rural setting, people have very specific rules if they're a farmer, whatever their profession... they have to face the inability to protect or care for their family" (Health Care Professional) (HP-04)

"You are always used to helping out, and now they've got to help you...." (Palliative Patient) (P-05)

Physical and Mental Health

"And I think like the rapid change in her condition, the weight loss, the jaundice, the diabetes, um, her incontinence, you know... that really... I, I think that really bothered her... Well it was her jaundice... number one was very, very acute. Um, she just wasn't eating - couldn't hold anything down. Um, she began getting more blood in her stools." (Family Caregiver) (C-07)

" When we first come on a case, I have found a lot of times we're dealing with pain control, a control of symptoms is one of the biggest things" (Health Care Professional) (HP-08)

"...as when something gets to a point and it's really, I'll sound like an idiot, it's like all of a sudden you have this brain problem...." (Palliative Patient) (P-05)

Activities of Daily Living

"Um...you know, she wanted to be the boss and that's all there was to it. ... But, you know, we did the general housekeeping things, we looked after her yard and her garden, did some shopping for her, and we were just there to spend time... Just to be with her." (Family Caregiver) (C-10)

"I think that one of the biggest changes or transitions that the palliative care patients go through is loss of independence and having to rely on someone else." (Health Care Professional) (HP-11)

"...I miss doing my usual stuff. Working for the hall, doing work at home, doing charity work... I miss doing that." (Palliative Patient) (P-06)