Concetta Yuhasz and her sister Denise Altice: "Family is what we know how to be." Belinda Ayers: "Regardless of our relationship, I would have been there to help." If there is no specific health directive, says Unwin, "in the middle of all that stuff, the family is asked to make decisions. The clinician tries to sort it out and advise on where to go with [treat40 | JANUARY/FEBRUARY 2016 ment and decisions]. Often the treatment [alternatives are] very sensitive." Family members are frequently left with "the say," says Wolford. An advance directive and some intelligent planning can help, but those don't necessarily deal directly with family dynamics which, says Wolford, "are sometimes driven by guilt; sometimes making sure I get my part" of the estate. Ultimately, CONTINUED ON PAGE 51 THEROANOKER.COM