PMID- 34866431
OWN - NLM
STAT- MEDLINE
DCOM- 20220818
LR  - 20230902
IS  - 1938-2715 (Electronic)
IS  - 1049-9091 (Print)
IS  - 1049-9091 (Linking)
VI  - 39
IP  - 9
DP  - 2022 Sep
TI  - Caregiver Challenges Seen From the Perspective of Certified Home Hospice Medical 
      Directors.
PG  - 1023-1028
LID - 10.1177/10499091211056323 [doi]
AB  - Background: Hospice medical directors (HMDs) play an important role as part of 
      the interdisciplinary hospice team. Family caregivers (CGs) play a critical role 
      in caring for patients receiving home hospice care. Understanding the challenges 
      HMDs face when working with CGs is important when addressing potential gaps in 
      care and providing quality end of life (EoL) care for the patient/CG dyad. 
      Objectives: To understand issues HMDs encounter when working with and caring for 
      CGs and to determine how they manage these issues in the home hospice setting. 
      Design: Twelve semistructured phone interviews with certified HMDs were 
      conducted. Data were analyzed using standard qualitative methods. Subjects: 
      Participants included certified HMDs obtained from a public website. Results: 
      Participants' responses regarding the major issues HMDs faced when working with 
      CGs were categorized into 6 themes: (1) assessing CG competency, (2) CG financial 
      burden, (3) physical burden of caregiving, (4) managing CG expectations, (5) CGs 
      denial of patient's terminal condition, and (6) CGs unwilling or unable to engage 
      with providers about their needs or the patient's needs. Conclusions: HMDs 
      confirmed the important role CGs play in providing care to home hospice patients. 
      Challenges faced by HMDs vary from assessing CG competency in providing care to 
      the patient, dealing with the physical and financial toll that CGs face, and 
      addressing CGs' expectations of hospice care. Future studies are needed to 
      explore solutions to these issues to better support CGs in the home setting.
FAU - Agarwal, Ankita
AU  - Agarwal A
AUID- ORCID: 0000-0002-8359-0848
AD  - 12295Weill Cornell Medicine, New York, NY, USA.
FAU - Alshakhs, Sulaiman
AU  - Alshakhs S
AD  - 12295Weill Cornell Medicine, New York, NY, USA.
FAU - Luth, Elizabeth
AU  - Luth E
AUID- ORCID: 0000-0003-1496-1235
AD  - 12295Weill Cornell Medicine, New York, NY, USA.
FAU - Dignam, Ritchell
AU  - Dignam R
AD  - 44198Visiting Nurse Service of New York, New York, NY, USA.
FAU - Reid, Manney C
AU  - Reid MC
AD  - 12295Weill Cornell Medicine, New York, NY, USA.
FAU - Adelman, Ronald D
AU  - Adelman RD
AD  - 12295Weill Cornell Medicine, New York, NY, USA.
FAU - Czaja, Sara J
AU  - Czaja SJ
AD  - 12295Weill Cornell Medicine, New York, NY, USA.
FAU - Phongtankuel, Veerawat
AU  - Phongtankuel V
AUID- ORCID: 0000-0002-7488-1264
AD  - 12295Weill Cornell Medicine, New York, NY, USA.
LA  - eng
GR  - K24 AG053462/AG/NIA NIH HHS/United States
GR  - K76 AG059997/AG/NIA NIH HHS/United States
GR  - K99 AG065624/AG/NIA NIH HHS/United States
GR  - R00 AG065624/AG/NIA NIH HHS/United States
PT  - Journal Article
DEP - 20211206
PL  - United States
TA  - Am J Hosp Palliat Care
JT  - The American journal of hospice & palliative care
JID - 9008229
SB  - IM
MH  - Caregivers
MH  - *Hospice Care
MH  - *Hospices
MH  - Humans
MH  - *Physician Executives
MH  - *Terminal Care
PMC - PMC9167893
MID - NIHMS1807348
OTO - NOTNLM
OT  - caregivers
OT  - caregiving
OT  - end of life
OT  - home hospice
OT  - hospice medical directors
OT  - palliative care
COIS- Declaration of Conflicting Interests The authors declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2021/12/07 06:00
MHDA- 2022/08/19 06:00
PMCR- 2023/09/01
CRDT- 2021/12/06 08:45
PHST- 2021/12/07 06:00 [pubmed]
PHST- 2022/08/19 06:00 [medline]
PHST- 2021/12/06 08:45 [entrez]
PHST- 2023/09/01 00:00 [pmc-release]
AID - 10.1177/10499091211056323 [doi]
PST - ppublish
SO  - Am J Hosp Palliat Care. 2022 Sep;39(9):1023-1028. doi: 10.1177/10499091211056323. 
      Epub 2021 Dec 6.