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.
In 2002, the World Health Organization (WHO) defined palliative care as an approach that aims to improve the quality of life (QoL) of patients and their
families who are facing problems associated with lifethreatening illness through the prevention and relief of suffering by early identification, careful assessment, and tailored treatment of physical, psychosocial, and
spiritual problems. Palliative care interventions are not only those provided by a service, in which all health care professionals have advanced training in
palliative care modern principles. In the great majority of the cases, especially in the early stages of the disease, palliative care interventions are the operationalization of palliative care principles, which should be
known and offered by any health care professional. They comprise a holistic approach to the patient, including life experiences and current situation, the aim of maintaining and promoting patients’ and family caregivers’ quality of life, the optimization of symptomatic management, and the establishment of an open communication with the patient, family, and
the interdisciplinary team. On the other hand, specialized palliative care services act as a resource for other health care fields. They provide support and advice for patients with more complex and demanding care
needs and train the rest of the team in palliative care principles.
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