Research That Matters (January 17 - 20, 2008)

Hospice social workers provide both emotional and instrumental support as one aspect of hospice services that are designed to reduce the burden of caregiving at the end of life. Yet, the impact of this support has not always been well documented. There are some conflicting notions of the burden of caregiving, including a clearly documented evidence of negative consequences of caregiving (Schultz & Beach, 1999)as well as positive aspects of caregiving (Nolan et.al., 1996; Cohen et. al., 2002), and evidence of ambiguities (Ayres, 2000). One large, urban hospice implemented a quality improvement project designed to improve the consistency of addressing caregiver issues by including a routine, standardized assessment tool of caregiver needs on admission to hospice services. The purpose of this study was to assess social work compliance with the implementation of this tool, and to identify social work interventions and outcomes focused on caregiver strain. Data were obtained from a retrospective chart review of 181 cases. For 91 cases, assessed caregiver strain on 11 items, at two points in time (upon admission to hospice services, and at the next follow up visit) was compared. Interventions, as recorded on treatment plans, were coded to reflect specific actions targeted at aspects of caregiver strain or burden. Paired-samples T-test results reveal significant(<.001) reduction in caregiver burden following hospice intervention (t=4.548). Age and gender of the caregiver were not significant predictors of caregiver burden, but the length of stay on hospice was positively associated with reduction in caregiver strain. Implications for social work and hospice include the impact of short lengths of stay, and possible gender bias in assessment of caregiver strain, as reflected in treatment plans.