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ReferencesAARP Public Policy Institute (2015). Caregiving in the U.S. Retrieved from L., Dalwadi, S.M. & Jacobson, J.O. (2017). Supporting the Supporters: What Family Caregivers Need to Care for a Loved One with Cancer. Journal of Oncology Practice, 13(1), 82-93. Brassard, A. (2012). Removing barriers to advanced practice registered nurse care: Home health and hospice services (p. 3). Washington (D.C.): AARP Public Policy Institute.Doris, T. (2007). Care for the family in palliative care. J Pall Med, 2, 26-30.Engen, N. (2017). Interventions to Alleviate the Psychosocial Needs of Hospice Family Caregivers: A Systematic Review.Farmer, B. (2020, January 23). Patients Want A \\\\\\\\\\\\\\\'Good Death\\\\\\\\\\\\\\\' At Home, But Hospice Care Can Badly Strain Families. Retrieved October 13, 2020, from https://khn.org/news/home-hospice-care-unexpectedly-burdens-family-caregivers/ Fay, M. (2019, April 02). End-of-life Options - Hospice Costs & Who Pays for Care. Retrieved October 13, 2020, from https://www.debt.org/medical/hospice-costs/ Given, B. A., Given, C. W., Stommel, M., & Lin, C. S. (1994). Predictors of use of secondary carers used by the elderly following hospital discharge. Journal of aging and health, 6(3), 353-376.Grabel, E., Trilling, A., Donath, C. &Luttenberger, K. (2010). Support groups for dementia caregivers - Predictors for utilization and expected quality from a family caregiver\\\\\\\\\\\\\\\'s point of view: A questionnaire survey PART I. BMC Health Serv Res., 10(4), 214-219. Hoffmann, R.L. & Mitchell, A.M. (2007). Caregiver Burden: Historical Development. Nursing Forum, 33(4), 5-12. Huelat, B. &Pochron, S.T. (2020). Stress in the Volunteer Caregiver: Human-Centric Technology Can Support Both Caregivers and People with Dementia. Medicina, 56, 256-270. Jack, B. A., O\\\\\\\\\\\\\\\'Brien, M. R., Scrutton, J., Baldry, C. R., & Groves, K. E. (2015). Supporting family carers providing end?of?life home care: a qualitative study on the impact of a hospice at home service. Journal of Clinical Nursing, 24(1-2), 131-140.McMillan, S. C., Small, B. J., Weitzner, M., Schonwetter, R., Tittle, M., Moody, L., & Haley, W. E. (2006). Impact of coping skills intervention with family caregivers of hospice patients with cancer: a randomized clinical trial. Cancer, 106(1), 214-222.Nabili, S. N. (2018, August 21). Hospice: Facts About the History of Hospice and Respite Care. Retrieved October 13, 2020, from https://www.medicinenet.com/hospice/article.htm National Hospice and Palliative Care Organization. (NHPCO). (2012). NHPCO facts and figures: hospice care in America. National Hospice and Palliative Care Organization. http://www.nhpco.org/sites/default/files/public/Statistics_Research/2012_Facts_Figures.p dfNorthouse, L. L., Katapodi, M. C., Schafenacker, A. M., & Weiss, D. (2012, November). The impact of caregiving on the psychological well-being of family caregivers and cancer patients. In Seminars in oncology nursing (Vol. 28, No. 4, pp. 236-245). WB Saunders.Oechsle, K., Ullrich, A., Marx, G., Benze, G., Heine, J., Dickel, L. M., ... &Bokemeyer, C. (2019). The psychological burden in family caregivers of patients with advanced cancer at the initiation of specialists inpatient palliative care. BMC Palliative Care, 18(1), 102.Oliver, D. P., Demiris, G., Washington, K. T., Clark, C., & Thomas-Jones, D. (2017). Challenges and strategies for hospice caregivers: a qualitative analysis. The Gerontologist, 57(4), 648-656.Otis-Green, S., & Juarez, G. (2012, November). Enhancing the social well-being of family caregivers. In Seminars in oncology nursing (Vol. 28, No. 4, pp. 246-255). WB Saunders.Parmar, J., Anderson, S., Abbasi, M., Ahmadinejad, S., Brémault-Phillips, S., Chan, K., ... & Tian, P. G. J. (2020). Support for family caregivers: A scoping review of family physician\\\\\\\\\\\\\\\'s perspectives on their role in supporting family caregivers. Health & social care in the community, 28(3), 716-733.Pottie, C. G., Burch, K. A., Montross Thomas, L. P., & Irwin, S. A. (2014). Informal caregiving of hospice patients. Journal of Palliative Medicine, 17(7), 845-856.Reinhard, S. C., Given, B., Petlick, N. H., & Bemis, A. (2008). Supporting family caregivers in providing care. In-Patient safety and quality: An evidence-based handbook for nurses. Agency for Healthcare Research and Quality (U.S.).Ullrich, A., Ascherfeld, L., Marx, G., Bokemeyer, C., Bergelt, C., &Oechsle, K. (2017). Quality of life, psychological burden, needs, and satisfaction during specialized in-patient palliative care in family caregivers of advanced cancer patients. BMC Palliative Care, 16(1), 31.Vanderwerker, L. C., Laff, R. E., Kadan-Lottick, N. S., McColl, S., &Prigerson, H. (2005). Psychiatric disorders and mental health service use among caregivers of advanced cancer patients. Journal of Clinical Psychology, 23(28), 11-19. Whitters, D. (2012). In U.S., Caregivers\\\\\\\\\\\\\\\' Emotional Health Often Suffers Negative emotional effects of caregiving greatest for those younger than 45. The Gallup Poll: Public Opinion 2011 (p. 186). Rowman & Littlefield Publishers.AppendixTable 1Well-being Sub-index Scores: Caregivers verses Non-CaregiversAmong those employed full time.Gallup-Healthways Well-Being Index. January 2, 2010- November 24, 2010Figure 2Matrix Table Source Citation Purpose/Problem Design/Sample Instruments/Measures[Include Reliability/Validity] Results[Include actual data] Strengths/Weaknesses Berry, L., Dalwadi, S.M. & Jacobson, J.O. (2017). Supporting the Supporters: What Family Caregivers Need to Care for a Loved One with Cancer. Journal of Oncology Practice, 13(1), 82-93. The authors of the present article propose a framework for advancing the relevant support to cancer patients\\\\\\\\\\\\\\\' caregivers. N/A N/A The authors make a finding to the effect that a four-part framework would be ideal in advancing support to caregivers. The framework comprises of the following steps: caregiver needs assessment, caregiver education, caregiver empowerment, and proactive assistance to caregivers. Strength: The authors, in this case, focus on a patient constituency that routinely needs caregiver support, i.e., patients with cancer. According to the authors, \\\\\\\\\\\\\\\"an estimated 4.6 million people in the United States care for someone with cancer at home\\\\\\\\\\\\\\\" (82). Thus, the author\\\\\\\\\\\\\\\'s findings would find a worthy and broad-based application. Weakness: It is, however, essential to note that the study is limited by its focus on only two very broad categories of caregivers, i.e., those caring for patients having metastatic cancer that is at an advanced stage and those caring for cancer patients undergoing therapy meant to cure the disease. This is a relatively narrow perspective, considering the broad nature of the caregiver burden problem. Grabel, E., Trilling, A., Donath, C. &Luttenberger, K. (2010). Support groups for dementia caregivers - Predictors for utilization and expected quality from a family caregiver\\\\\\\\\\\\\\\'s point of view: A questionnaire survey PART I. BMC Health Serv Res., 10(4), 214-219. The authors seek to identify the various factors that influence or impact caregiver support quality amongst dementia patients. The cross-sectional study was undertaken in a total of 4 regions – each having a minimum of 2,500 patients. A 3-page questionnaire was utilized. For acceptability and comprehensibility, the said questionnaire was tested on a total of twelve caregivers. The authors make a finding to the effect that caregivers agreed that the relevance of psycho-educative orientation could not be overstated. Strength: The focus on numerous regions gives the study findings broad applicability. Weakness: In seeking to analyze data from a total of 404 caregivers, the study made use of both binary logistic regression analysis and content analysis. Although the former statistical technique could come in handy to better comprehend the actual impact of independent variables, it is rather limited to predicting continuous outcomes. Hoffmann, R.L. & Mitchell, A.M. (2007). Caregiver Burden: Historical Development. Nursing Forum, 33(4), 5-12. The present article concerns itself with the caregiver burden concept – from a historical viewpoint. N/A N/A As per the authors of the article, the idea of caregiving has undergone various transitions over the last few decades. StrengthThe article reviews the initiation of the caregiver burden right from the onset – i.e., the 1950s and the successful evolution of the caregiver burdenWeakness: The article is somewhat outdated – having been published more than a decade ago. Huelat, B. &Pochron, S.T. (2020). Stress in the Volunteer Caregiver: Human-Centric Technology Can Support Both Caregivers and People with Dementia. Medicina, 56, 256-270. The study mainly concerns itself with the concept of \\\\\\\\\\\\\\\"caregiver stress burden and explore potential technologies and behaviors to ease it\\\\\\\\\\\\\\\" (257). In the present study, the authors elected to use a qualitative, exploratory design founded on hermeneutical methodology. Questionnaires were utilized – with two caregiver kinds being the focus of the interview. The authors found that amongst home-based caregivers, the primary source of stress burden was dementia symptoms. This is more so when it comes to hygiene care, memory loss, and medication management. Further, it was also found that access to the available resources was of great relevance in as far as stress relief is concerned. StrengthThe authors relied upon numerous peer-reviewed sources in support of their findings – hence promoting reliability. Weakness: However, their utilization of an exploratory design essentially resulted in the generation of qualitative info. It is important to note that the interpretation of information of this kind could result in bias to no small extent. Vanderwerker, L. C., Laff, R. E., Kadan-Lottick, N. S., McColl, S., &Prigerson, H. (2005). Psychiatric disorders and mental health service use among caregivers of advanced cancer patients. Journal of Clinical Psychology, 23(28), 11-19. In the present study, the authors sought to map the prevalence of both mental health services and psychiatric disorders among those in caregiver roles. Interviews were conducted, targeting a total of 250 informal caregivers. The Structured Clinical Interview of the Diagnostic and Statistical Manual of Mental Disorders – 4th ed. – was administered to interviewees. The study found that \\\\\\\\\\\\\\\"many caregivers of advanced cancer patients either meet criteria or are being treated for psychiatric problems\\\\\\\\\\\\\\\" (18). StrengthThis is the only study found that focused on the psychiatric disorder\\\\\\\\\\\\\\\'s prevalence amongst caregivers. The psychiatric disorder frequencies were highlighted.Weakness: Although this happens to be a peer-reviewed article, the fact that it was published more than a decade ago could limit the applicability of some of its conclusions in a contemporary scenario. Oechsle, K., Ullrich, A., Marx, G., Benze, G., Heine, J., Dickel, L. M., ... &Bokemeyer, C. (2019). The psychological burden in family caregivers of patients with advanced cancer at the initiation of specialist in-patient palliative care. BMC Palliative Care, 18(1), 102. The study aimed to systematically evaluate distress, depressive and anxiety symptoms in the defined cohort of F.C.s of advanced cancer patients. This prospective multicenter research was carried out in two University Medical Centers in Germany with similar F.C.s support structures. F.C.s completed the questionnaires that included German versions of various standardized and mostly validated scales to measure distress, depressive and anxiety symptoms Out of 23 given problems, the five most frequently reported ones were sadness in 91% (n?=?209), sorrows in 90% (n?=?202), anxiety in 78% (n?=?173), exhaustion in 77% (n?=?171), and sleep disturbances in 73% (n?=?163) of F.C.s. The data assessed in this study are housed at the Palliative Care Unit, Department of Oncology, Hematology, and BMT, University Medical Center HamburgAlternatively, interrelationships of mental burden in dyads of patients and their F.C.s also raise the question, when individual versus dyadic interventions are most beneficial. Oliver, D. P., Demiris, G., Washington, K. T., Clark, C., & Thomas-Jones, D. (2017). Challenges and strategies for hospice caregivers: a qualitative analysis. The Gerontologist, 57(4), 648-656. This study\\\\\\\\\\\\\\\'s goal was to comprehend the problems and coping methods used by hospice caregivers while they take care of family members. This study is a secondary data analysis from an attention control group in a large randomized controlled trial testing a cognitive-behavioral intervention with hospice caregivers. Audiotaped interviews were coded with initial themes and combined into final categories of caregiving challenges and strategies for managing the hospice caregiving experience. The sample included 52 caregivers who participated in a total of 205 phone calls (average of 3.9 of 4.0 per participant) for a total of nearly 58hr. Each interview averaged 33min and ranged from 2 to 60min. Caregivers had been an average of 62 years old, primarily female (77%), white (90%), and were most often adult children of the patient (56%). The majority had been caregiving for more than one year. Patients were an average of 82 years old and predominately female (65%). A third of the patients had a cancer diagnosis, and nearly a fourth had a diagnosis of dementia or a related disorder. The caregivers in the study described similar challenges as those reported in previous studies. Narratives discussed emotions, including anxiety, depression, stress, and relationship issues, all found in former research. Although data saturation was achieved, the findings cannot be generalized to a broader or more diverse population from these data alone. McMillan, S. C., Small, B. J., Weitzner, M., Schonwetter, R., Tittle, M., Moody, L., & Haley, W. E. (2006). Impact of coping skills intervention with family caregivers of hospice patients with cancer: a randomized clinical trial. Cancer, 106(1), 214-222. The study determined if hospice and a coping skill training intervention developed family caregivers\\\\\\\\\\\\\\\' QOL, stress, coping, and mastery, versus with hospice and emotional support, and general hospice care. A three-group randomized controlled trial was conducted, including baseline, 16 days, and 30-day analysis from March 1999 until May 2003. The participants included 354 family caregivers of community-dwelling hospice patients with advanced cancer. Inclusion Criteria: caregivers had to be giving care to adult patients who have cancer. Both had to give their consent to participate, have at least a sixth-grade schooling, and acquire at least a score of 7 on the Short Portable Mental Status Questionnaire. Exclusion criteria: caregivers had been excluded in case they were in active therapy for cancer themselves. The coping skills intervention effectively improved caregiver QOL, cutting down the burden involving patients\\\\\\\\\\\\\\\' symptoms and caregiving tasks versus hospice care alone or hospice and emotional support. Because this intervention has been developed into a manual, it is replicable and can be easily used by professionals offering end?of?life care in several contexts. Only one element, younger patient age, anticipated attrition. It is unclear why younger individuals had higher attrition, but this result proposes that advanced age does not preclude involvement in this kind of trial. Engen, N. (2017). Interventions to Alleviate the Psychosocial Needs of Hospice Family Caregivers: A Systematic Review. This systematic review was developed to respond to what interventions happen to be available to alleviate the psychosocial needs of hospice family caregivers. This systematic review gathered and analyzed empirical peer-reviewed articles to determine what interventions exist for hospice family caregivers. This research\\\\\\\\\\\\\\\'s inclusion criteria had been as follows: all articles analyzed for this systematic review were empirical peer-reviewed studies. Both quantitative and qualitative articles had been considered for this research. The chosen time frame was 2000 to present as studies have shown growth both within the number of people receiving hospice services and the recognition to implement services that support patient and families\\\\\\\\\\\\\\\' psychosocial needs. Reasons for exclusion included support explored for bereaved family members instead of support while the family member provided care. Two key patterns materialized from the data, education opportunities and counseling services, and both of these were further broken down into informal education and psychoeducation. This study has shown that hospice caregivers often have difficulty identifying their individual needs, as so much of their focus is on the needs of patient\\\\\\\\\\\\\\\'s needsOne significant limitation of this research is the accessible data that centers on the demand of family caregivers. From the set of inclusion criteria carried out, only 11 papers had been extracted Oechsle, K. (2019). Current advances in palliative & hospice care: Problems and needs of relatives and family caregivers during palliative and hospice care—An overview of current literature. Medical Sciences, 7(3), 43. The narrative analysis offers an expert summary of peer-reviewed, English-centered original publications and analysis on psychosocial and existential issues, supportive demands, and interventions for relatives during the patients\\\\\\\\\\\\\\\' disease trajectory published between January 2017 and November 2018. A total of 64 publications were included. This narrative review includes all relevant peer-reviewed publications on psychological morbidity and burden, quality of life, existential distress, preparedness/self-efficacy, supportive needs as well as on supportive interventions and the role of specialist palliative and hospice care in patients with advanced incurable diseases during disease trajectory published within the last two years. Relatives report high levels of existential and psychological distress, burden, and mental morbidity through the patient\\\\\\\\\\\\\\\'s total disease trajectory. Overall, the discussed studies strengthen previous data reporting high rates of psychological and existential distress, psychosocial burden, and psychological morbidity in relatives during the patients\\\\\\\\\\\\\\\' disease trajectoryDespite the author\\\\\\\\\\\\\\\'s effort to review all relevant topic-related studies from the last two years, possibly some could be missed. The review involves subjective selection bias due to methodological reasons: Search media was restricted to one search engine (PubMed), and the literature search was not pre-defined protocol-based.https://www.aarp.org/content/dam/aarp/ppi/2015/caregiving-in-the-us-research-report-2015.pdf Berry,
