Journal of social work in end-of-life & palliative care
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J Soc Work End Life Palliat Care · Jan 2010
Levels, types, and predictors of family caregiver strain during hospice home care for an older adult.
Academic researchers and professionals from a hospice organization collaborated to assess physical, emotional, social, economic, and spiritual strain stemming from providing care to a terminally ill older relative among 162 family caregivers to older adults newly admitted to hospice home care. The study investigated predictors of the different types of strain, as well as cumulative strain. Hierarchical multiple regressions revealed that caregivers' age and race, hospice patients' major illnesses (particularly cancer), caregivers' appraisals of their situation, and resources were significant risk or protective factors for caregiver strain, although the predictors varied by type of strain and amount of strain. Discussion focuses on the importance of identifying family caregivers at risk of higher strain during hospice home care and implications for family caregiver interventions.
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J Soc Work End Life Palliat Care · Jan 2010
Life-sustaining treatment decisions: a social work response to meet needs of health care surrogates.
Surrogates must possess essential patient information prior to legitimately exercising legal and moral obligations to act on patients' medical care preferences. This descriptive, in vivo study examined factors influencing surrogate and proxy decisions (N = 132) following life-sustaining treatment decisions. ⋯ Guided by patients' advanced communication, respondents (97.8%) expressed high self-reliance and significant appreciation of benefits associated with their decisions. Clarifying surrogates' and providers' understanding of patient care preferences during ICU/CCU admission may facilitate better adherence to patient wishes.