Evaluation of a night respite community palliative care service

Kristjanson, Linda J.; Cousins, Kerry; White, Kathryn; Andrews, Lara; Lewin, Gill; Tinnelly, C.M. Joseph T.; Asphar, Dianne; Greene, Ros

doi:10.12968/ijpn.2004.10.2.12453

Cited by 35 publications

(42 citation statements)

References 12 publications

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“…A sizable body of evidence exists that describes the family caregiver's experience and needs [10,11,50,51]; however, very little is known about which interventions are most e ective for supporting family caregivers as they provide palliative care. ree recent studies suggests some promising interventions such as: (a) a pilot-study of a night respite service aimed at reducing family caregiver fatigue and sleep promotion [52]; (b) a three-session group psycho-educational program that increases perceived family caregiver competence and preparedness to care [53]; and, (c) a program designed to increase a family caregivers' sense of hope [54]. All of these interventions reStajduhar.…”

Section: Future Directions To Support Family Caregiversmentioning

confidence: 99%

Burdens of Family Caregiving at the End of Life

Stajduhar¹

2013

CIM

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A patient's ability to be cared for and to die at home is heavily dependent upon the e orts of family caregivers. Considerable stresses are associated with such caregiving, including physical, psychosocial and nancial burdens. Research has shown that unmet needs and dissatisfaction with care can lead to negative outcomes for caregivers. While many family caregivers also report caregiving as life-enriching, some report that they would prefer alternatives to care at home, primarily because of these associated burdens. Little is known about which interventions are most e ective to support family caregivers ministering palliative care at home. Well-designed studies to test promising interventions are needed, followed by studies of the best ways to implement the most e ective interventions. Clinically e ective practice support tools in palliative home care are warranted to identify family caregiver needs and to ensure that patients and their family caregivers have a choice about where care is provided. The aging population, the growing number of Canadians diagnosed with chronic life-limiting illness, and the fact that a large majority of Canadians report that they prefer to spend their nal days at home [1,2,3] are converging to prompt government policy to press for more and better care of dying people in the community [4]. Patients' ability to be cared for and to die at home, however, is heavily dependent upon the e orts of family caregivers [5]. Even where patients receive home care services, the likelihood of dying at home is dramatically reduced if family caregivers are unable to provide care [6]. SPECIAL SERIES -END OF LIFE CAREAbout 80% of all care at home is provided by family caregivers [7]. Recent estimates suggest that Canada's 1.5 to 2 million family caregivers provide $25 to $26 billion worth of care annually and incur $80 million in out-of-pocket expenses annually [8]. Not only are family caregivers the 'invisible' providers within our health care system in Canada, but they have emerged as the principle source of support for patients who are dying at home.ough normally willingly undertaken [9], caregiving at the end of life entails considerable cost for family caregivers and the wider family, incurring emotional, social, physical and nancial costs [10,11]. e toll of care extends even into bereavement; people who are at least somewhat distressed by caregiving are 63% more likely to die in the four years following the patient's death than those who were not distressed or than the bereaved who did not give care [12]. Indeed, the Public Health Agency of Canada identi es the issue of 'seniors caring for seniors' as a public health concern in need of attention.Canada's Family Caregivers: Who Are ey? e vast majority of family caregivers in Canada are female (77%); about 70% are 45 years of age or older and about 25% are at least 65 years of age. us, women aged 45 and older comprise 51% of Canada's family caregiver population [13]. Consistent with these characteristics, Canada's family caregivers are most...

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Section: Future Directions To Support Family Caregiversmentioning

confidence: 99%

Burdens of Family Caregiving at the End of Life

Stajduhar¹

2013

CIM

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“…The findings of the studies that do exist are equivocal, probably due to the heterogeneity of palliative care services, study populations, settings, and designs. [17][18][19][20][21][22][23][24][25] Moreover, few studies have evaluated the relationship between involvement of palliative care services and place of death considering primary health care use, and none have evaluated the impact of a complete palliative care model, including all palliative care services for all patients in all health care settings, on place of death in a particular country.…”

Section: Introductionmentioning

confidence: 99%

Involvement of Palliative Care Services Strongly Predicts Place of Death in Belgium

Houttekier

Cohen

Block

et al. 2010

Journal of Palliative Medicine

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Introduction: Place of death is considered a quality indicator of end-of-life care and enabling people to die were they choose is an important aspiration of palliative care. This study aims to examine the association between involvement of palliative care services and place of death. Methods: Data about patient characteristics, use of general health care, and involvement of palliative care services in nonsudden or expected deaths in all health care settings in 2005-2006 (N ¼ 1690) were collected by a surveillance network of general practitioners (GPs) in Belgium. Bivariate and multivariate associations between involvement of palliative care services and dying at home, in hospital, in a care home, or in a palliative care unit were examined using w 2 tests and Wald tests. Results: Palliative care services were involved in 21.8% of deaths of those living at home, in 29.1% of those living in care homes, and in 12.4% of deaths in hospital. People were more likely to die in their usual residence rather than in hospital if multidisciplinary palliative home care teams (odds ratio [OR]: 8.4, confidence interval [CI]: 4.7-15.1) or the palliative care reference persons of their care home (OR: 9.4, CI: 3.3-26.7) were involved. Involvement of multidisciplinary palliative support teams in hospitals was associated with lower chances of dying at home (OR: 0.3, CI: 0.1-0.9). High involvement of GPs was not directly associated with out-of-hospital death. Discussion: Involving multidisciplinary palliative home care teams and palliative care reference persons in care homes could support people in dying out-of-hospital. Health care policy-makers should consider strategies to improve involvement of palliative care services in all health care settings.

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“…Using the label support, researchers have reported on studies in which various interventions have been implemented that departed from a natural science point of view in their design and that were concerned with describing actions and reactions. Telephone support (Chang, Nitta, Carter, & Markham, 2004), online support (Glueckauf, Ketterson, Loomis, & Dages, 2004), respite care (Kristjanson et al, 2004), day care services (Dröes, Breebaart, Meiland, van Tilburg, & Mellenbergh, 2004), and group sessions (Harding, Higginson, et al, 2004) are a few examples of recently tested approaches. Evaluations of interventions or descriptions of reactions to caregiving are recurrently done from at stresscoping point of view, whereby burden (Hirschman, Shea, Xie, & Karlawish, 2004), anxiety (Richards, Moniz-Cook, Duggan, Carr, & Wang, 2003), depression (Beeson, 2003;Covinsky et al, 2003), or quality-of-life (Lincoln, Walker, Dixon, & Knights, 2004;Sands, Ferreira, Stewart, Brod, & Yaffe, 2004) scales are used to evaluate caregiver outcomes or describe caregiving.…”

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confidence: 99%