Family Caregivers' Confidence Caring for Relatives in Hospice Care at Home: An Exploratory Qualitative Study

Objectives: Although the experiences of family caregivers have received attention, little research has specifically explored caregivers' confidence. Evidence shows that caregivers of hospice patients do not feel confident or prepared to care for relatives or friends who die at home. Aim: We aimed to elicit the views, feelings, and experiences of primary caregivers who provide unpaid care to dying family members in the home setting to better understand what contributes to their confidence during end-of-life care. Design: The exploratory, cross-sectional design involved semistructured, in-depth interviews. A narrative analysis that focused on form and content was chosen to analyze the data. Participants: Sixteen bereaved caregivers (14 individuals and 1 brother/sister dyad) from the midwestern United States who received support from 1 hospice participated in the study. Results: Four storylines running longitudinally through the interviews were identified as shaping, giving meaning to, and contextualizing caregivers' confidence: values/relationships, stories of terminal illness, needs, and support. Caregivers' confidence is shaped by the terminal illness of the person for whom they care and caregivers' values and relationships. It is also influenced by their needs and the sources and strength of support they receive. Conclusions: This research developed understanding about family provision of end-of-life care at home. Better comprehension of caregivers' experiences can help professional hospice and palliative care staff to understand what aids caregivers to be more confident.