“How Long Can I Carry On?” The Need for Palliative Care in Parkinson’s Disease: A Qualitative Study from the Perspective of Bereaved Family Caregivers

Abstract

Background: Family caregivers provide the majority of care for people with Parkinson’s disease (PD) in the palliative care phase. For many this is a demanding experience, affecting their quality of life. Objective: We set out to map the experiences of bereaved family caregivers during the period of informal care in the palliative care phase as well as after the death of their loved one with PD. Methods: Ten bereaved family caregivers participated in this qualitative study. Semi-structured interviews were conducted and interpretative phenomenological analysis was used executed. Results: We identified four main themes. 1) Feeling like a professional caregiver: while caring for a person with PD, the family caregivers took over many roles and tasks of the person with PD. 2) Healthcare professionals do not always know what PD really means: most interviewees had negative experiences with knowledge and understanding of PD of, especially, (practice) nurses. 3) Being on your own: many respondents had felt highly responsible for their loved one’s care and lacked time and space for themselves. Grief and feelings of guilt were present during the caregiving period and after death. 4) Being behind the times: to provide palliative care in line with patients’ preferences and to feel prepared for the palliative care phase of PD, proactive palliative care planning was considered important. However, the interviewees told that this was most often not provided. Conclusion: These findings indicate that caring for a person with PD in the palliative care phase is a demanding experience for family caregivers. They experience psychological problems for many years before and after the death of the person with PD. Increasing healthcare professionals’ awareness of family and bereaved caregivers’ needs may mitigate these long-term detrimental effects.

“No One Can Tell Me How Parkinson’s Disease Will Unfold”: A Mixed Methods Case Study on Palliative Care for People with Parkinson’s Disease and Their Family Caregivers

“…Bereavement support consisted of an expression of sympathy from the health care professional involved, who, however, did not provide information about grief, bereavement, or other support services. This finding is in line with our previous qualitative interview study on the experiences of bereaved family caregivers, to the effect that bereavement programs were not routinely offered [ 20 ]. Furthermore, society cultural norms ‘to continue’ and ‘to go on’ might not be helpful in the long term.…”

The experience of care partners of patients with Parkinson’s disease psychosis

“…To our knowledge, this is the first such report of qualitative interviews of care partners dealing with PDP. The themes uncovered by our analysis are consistent with other qualitative analyses of PD care partner experience [ 14 – 16 ] and the experience of care partners of those with other causes of psychosis [ 17 ], including the challenges of self-care while caregiving and the need for better care partner support.…”

The Experience of Care Partners of Patients with Parkinsonism and Psychosis

“…To our knowledge, this is the first such report of qualitative interviews of care partners dealing with PDP. The themes uncovered by our analysis are consistent with other qualitative analyses of PD care partner experience [14–16] and the experience of care partners of those with other causes of psychosis [17], including the challenges of self-care while caregiving and the need for better care partner support.…”