Mindfulness to Enhance Quality of Life and Support Advance Care Planning

Inclusion Criteria-Patients

* Patient is at least 18 years of age.
* Patient is at least 3 weeks post-diagnosis of an incurable (locally advanced or metastatic) solid malignancy.
* Patient's attending medical oncologist would not be surprised if the patient died in the next 12 months.
* Patient has not completed a POST form.
* Patient scores ≥ 7 on the Mini-Mental Adjustment to Cancer cognitive avoidance subscale.
* Patient is willing and able to consent and travel to the class location for 6 weekly 2-hour sessions.
* Patient has a family member or close friend eligible and interested in participating in the study.
* Patient has adequate English fluency for completion of data collection

Inclusion Criteria-Family Care Givers (FCG)

* FCG is at least 18 years of age.
* FCG has been invited to participate in the trial with a patient who meets eligibility criteria above.
* FCG is willing and able to consent and travel to the class location for 6 weekly 2-hour sessions.
* FCG has adequate English fluency for completion of data collection

Exclusion Criteria-Patients

* Patient reports a score of \> 2 on the Activities and Function item from the Patient Generated Subjective Global Assessment91 (PG-SGA; the patient-reported version of the Eastern Cooperative Oncology Group score).
* Patient makes 3 or more errors on a validated 6-item cognitive screener or exhibits significant psychiatric or cognitive impairment (e.g., dementia/delirium, retardation, active psychosis) that in the judgment of the investigators would preclude providing informed consent and study participation.
* Currently receiving hospice care (patients who enroll in hospice during the trial will have the option of continuing trial participation).

Exclusion Criteria-FCGs

• FCG exhibits significant psychiatric or cognitive impairment (e.g., dementia/delirium, retardation, active psychosis) that in the judgment of the investigators would preclude providing informed consent and study participation.