Pathways: This large longitudinal project is following 241 patients and their caregivers over several years to learn about the continuum of changes that patients and caregivers undergo as they deal with serious illness and dying. Investigators will examine the: changes in patients’ physical symptoms, physical function, emotional function, quality of life, preparation for death, spirituality, and awareness of dying; progression in caregivers’ grief, burden, and awareness of dying; effects of ethnicity, disease type, and other variables on these trajectories; and the timing of patients’ and caregivers’ realization that the patient was dying. The information gathered will help specialists improve the quality of palliative care offered to the seriously ill and dying.

Principal Investigator: Dr. James Tulsky

 Annallys Goodwin-Lander (919) 668-7211.