TY - JOUR
T1 - Symptom Management Experience of End-of-Life Family Caregivers
T2 - A Population-Based Study
AU - Mather, Harriet
AU - Kleijwegt, Hannah
AU - Bollens-Lund, Evan
AU - Kelley, Amy S.
AU - Ornstein, Katherine A.
N1 - Funding Information:
ASK is supported by a K24 ( 5K24AG062785 ), P30 ( 5P30AG028741 ), P01 ( 5P01AG066605 ). KAO is supported by an R01 ( 5R01AG60967-03 ), P30 ( 5P30AG028741 ), P01 ( 5P01AG066605 ). The funding bodies had no involvement in study design, data collection, analysis, interpretation, report writing, or decision to submit.
Publisher Copyright:
© 2022 American Academy of Hospice and Palliative Medicine
PY - 2022/12
Y1 - 2022/12
N2 - Context: In the United States, 30% of all deaths occur at home. Effective symptom management is integral to quality end-of-life (EOL) care. Family caregivers play a major role in EOL symptom management. Recent federal policies emphasize the need to improve training and support for family caregivers. Objectives: In a nationally representative sample: 1) Characterize the population of caregivers assisting with and reporting difficulty in symptom management at the end of life; and 2) Assess caregiver and care recipient characteristics associated with caregiver report of difficulty. Methods: Cross-sectional analysis of data from the National Health and Aging Trends Study and National Study of Caregiving. Multivariable logistic regression to assess association between care recipient and caregiver characteristics and caregiver report of difficulty. Results: Caregivers (n = 214) were mean age 57.1 years, 74% female, and 86% white non-Hispanic. Over 2 million family caregivers provided assistance with symptom management in the last month of life in 2017; 78% reported difficulty. Non-Hispanic Black caregivers (aOR 0.24, 95% CI 0.08–0.75), Hispanic caregivers (0.13, 0.03–0.56), and caregivers with lower than high school education (0.26, 0.11–0.63) were less likely to report difficulty. Caregivers of care recipients who received paid care (3.37, 1.30–8.69) were more likely to report difficulty. Receipt of training and support services (1.80, 0.83–3.93) and hospice (1.83, 0.82–4.07) were not associated with caregiver report of difficulty. Conclusion: These findings underscore the need to improve training and support for family caregivers in EOL symptom management.
AB - Context: In the United States, 30% of all deaths occur at home. Effective symptom management is integral to quality end-of-life (EOL) care. Family caregivers play a major role in EOL symptom management. Recent federal policies emphasize the need to improve training and support for family caregivers. Objectives: In a nationally representative sample: 1) Characterize the population of caregivers assisting with and reporting difficulty in symptom management at the end of life; and 2) Assess caregiver and care recipient characteristics associated with caregiver report of difficulty. Methods: Cross-sectional analysis of data from the National Health and Aging Trends Study and National Study of Caregiving. Multivariable logistic regression to assess association between care recipient and caregiver characteristics and caregiver report of difficulty. Results: Caregivers (n = 214) were mean age 57.1 years, 74% female, and 86% white non-Hispanic. Over 2 million family caregivers provided assistance with symptom management in the last month of life in 2017; 78% reported difficulty. Non-Hispanic Black caregivers (aOR 0.24, 95% CI 0.08–0.75), Hispanic caregivers (0.13, 0.03–0.56), and caregivers with lower than high school education (0.26, 0.11–0.63) were less likely to report difficulty. Caregivers of care recipients who received paid care (3.37, 1.30–8.69) were more likely to report difficulty. Receipt of training and support services (1.80, 0.83–3.93) and hospice (1.83, 0.82–4.07) were not associated with caregiver report of difficulty. Conclusion: These findings underscore the need to improve training and support for family caregivers in EOL symptom management.
KW - end-of-life care
KW - family caregivers
KW - hospice
KW - palliative care
KW - symptom management
UR - http://www.scopus.com/inward/record.url?scp=85139736852&partnerID=8YFLogxK
U2 - 10.1016/j.jpainsymman.2022.07.017
DO - 10.1016/j.jpainsymman.2022.07.017
M3 - Article
C2 - 35944883
AN - SCOPUS:85139736852
SN - 0885-3924
VL - 64
SP - 513
EP - 520
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 6
ER -