Research Article
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Published Online: 13 September 2010

Exploring Factors that Influence Informal Caregiving in Medication Management for Home Hospice Patients

Publication: Journal of Palliative Medicine
Volume 13, Issue Number 9

Abstract

Objective: To explore factors that influence how informal caregivers manage medications as part of caring for hospice patients.
Methods: Semistructured, open-ended interviews were conducted with 23 informal caregivers and 22 hospice providers from 4 hospice programs in the Chicago metropolitan areas. Qualitative analysis was conducted consistent with the grounded theory approach.
Results: In general, informal caregivers and hospice providers identified similar key factors that facilitated or impeded caregivers' process in managing medications. Caregivers' life experience and self-confidence were considered assets that facilitated medication management. Limitations impeding the process included caregivers' negative emotional states, cognitive and physical impairments, low literacy, other competing responsibilities, as well as patients' negative emotional states and complex medication needs. Furthermore, the social context of medication management emerged as a salient theme: caregivers' good interpersonal relations with patients facilitated medication management, whereas poor communication/relations among caregivers within a support network impeded the process. While both study groups discussed the positive attributes of good caregiver–patient relations and support from multiple caregivers, hospice providers were cautious about the potential adverse influence of close relations with patients on caregivers' decision making about medications and discussed poor communication/relations among informal and privately hired caregivers that often resulted from family conflicts and/or a lack of long-standing leadership.
Conclusion: Our findings suggest additional intervention points, beyond knowledge and skill building, that could be addressed to support caregivers in executing medication responsibilities at home for hospice patients.

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Published In

cover image Journal of Palliative Medicine
Journal of Palliative Medicine
Volume 13Issue Number 9September 2010
Pages: 1085 - 1090
PubMed: 20836633

History

Published online: 13 September 2010
Published in print: September 2010
Accepted: 15 April 2010

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Authors

Affiliations

Denys T. Lau
Buehler Center on Aging, Health & Society, Northwestern University, Chicago, Illinois.
Department of Medicine, Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Rebecca Berman
Leonard Schanfield Research Institute at CJE SeniorLife, Chicago, Illinois.
Leslie Halpern
*
Buehler Center on Aging, Health & Society, Northwestern University, Chicago, Illinois.
A. Simon Pickard
Department of Pharmacy Practice, College of Pharmacy, University of Illinois, Chicago, Illinois.
Robert Schrauf
Department of Linguistics and Applied Language Studies, Pennsylvania State University, University Park, Pennsylvania.
Whitney Witt
Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.

Notes

Address correspondence to:Denys T. Lau, Ph.D.Buehler Center on Aging, Health, & SocietyNorthwestern University750 North Lake Shore DriveSuite 601Chicago, IL 60611E-mail: [email protected]

Author Disclosure Statement

No competing financial interests exist.

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