Abstract
BackgroundFamily caregivers are crucial in providing end-of-life care at home. Without their care, it would be difficult for many patients to die at home. In addition to providing care, family caregivers also need support for themselves. Nurses could play an important role in supporting family caregivers, but little is known about if and how they do so. The aim of this study is to explore how nurses currently approach and support family caregivers in end-of-life home care and which factors influence their support of family caregivers.MethodsData were collected using semi-structured interviews with 14 nurses from nine home care organisations in the Netherlands, in 2018. Interviews were audio-taped, transcribed verbatim and analysed using a thematic analysis approach.ResultsWe identified two underlying nursing perspectives on supporting family caregivers: an instrumental perspective (seeing family caregivers mostly as collaborative partners in care) and a relational perspective (seeing family caregivers as both providing and needing support). All the interviewed nurses stated that they pay attention to family caregivers’ needs. The activities mentioned most often were: identification of support needs, practical education, support in decision-making about the patient’s treatment, emotional support, and organising respite care, such as night care, to relieve the family caregiver. The provision of support is usually based on intuition and experience, rather than on a systematic approach. Besides, nurses reported different factors at the individual, organisational and societal levels that influenced their support of family caregivers, such as their knowledge and experience, the way in which care is organised, and laws and regulations.ConclusionsNurses tend to address family caregivers’ needs, but such care was affected by various factors at different levels. There is a risk that nursing support does not meet family caregivers’ needs. A more reflective approach is needed and evidence-based needs assessment tools may help nurses to systematically assess family caregivers’ needs and to provide appropriate support.
Highlights
Caregivers are crucial in providing end-of-life care at home
The transcripts of the interviews were anonymised. This results section starts with a description of the characteristics of the interviewed nurses, followed by an explanation of two nursing perspectives on family caregiving
This article focus on the question: how do nurses currently approach and support family caregivers in end-oflife home care, and which factors influence their support of family caregivers? Two nursing perspectives on supporting family caregivers were identified from the nurses’
Summary
Caregivers are crucial in providing end-of-life care at home. In addition to providing care, family caregivers need support for themselves. Caring for a relative might be rewarding [5, 6], being a family caregiver involves challenges. Many family caregivers are insufficiently prepared to cope with a situation where they need to take responsibility for the person’s physical and emotional care [8, 9]. As a result, they are prone to emotional, physical, social and financial distress [10,11,12]. Health care professionals should be able to recognise and support family caregivers in their tasks as caregivers but should provide them psychological and emotional support separate from the patients
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