Informal non-kin support for elderly people living alone and end of life care. Literature review

Background. Older people living alone are a disadvantaged group of society with regard to preferences for care, especially in the last phases of life. Non-kin carers seem to play a vital role for these people; however, these carers tend to be neglected in research as well as policy compared to professional care-givers or family members. Aim. In order to investigate how non-kin carers support older people living alone, e.g. to fulfill their preference for dying at home, a scoping review was carried out. Material and methods. The databases MEDLINE, CINAHL and GeroLit were searched and 12 studies were identified which form the basis of this review. Results. Non-kin care relationships are characterized by low key initial phases and often salient transition from support to permanent caring. Various motives for becoming involved can be found from the studies but a differentiation between relationships such as pure friendship, casual aquaintance and neighbors seem to be important. The needs of older people living alone are closely connected with their preference for staying at home. Conclusion. Non-kin carers face several challenges and have to deal with increasing needs for physical care towards the end of life. Palliative care services are most often involved at this phase. More research is needed to better understand the limits as well as ressources of non-kin carers and the interplay between them and professional carers.