Emotional and physical health of informal caregivers of residents at the end of life: the role of social support.
OBJECTIVE
The objectives of this study were to examine the relationship between selected decedent and caregiver characteristics, facility-related perceptions, and emotional and physical health of 434 informal caregivers (94% family) of recently deceased residents of residential care/assisted living facilities and nursing homes. We also examined potential mediating effects of social support (informal, staff, and spiritual).


METHODS
We analyzed data using linear mixed models.


RESULTS
Among caregivers, younger age, female gender, more education, financial burden, other dependents, poorer perceptions of care, and more care involvement were associated with more emotional strain. More staff support also was associated with more emotional strain and partially mediated the relationship between having a trusted staff member and emotional strain. Characteristics associated with poorer physical health included unemployment, financial burden, poorer physician communication, and trusted staff member. Informal social support was directly related to better physical health and mediated the relationships between physical health and both physician communication and financial burden.


CONCLUSIONS
Many characteristics related to end-of-life caregiving outcomes in long-term care are consistent with community-based studies, suggesting that end-of-life caregiving outcomes in long-term care are not markedly different than in other settings. However, the role of staff support may either facilitate or complicate emotional strain and merits additional study.
Department of Allied Health Sciences, Division of Speech and Hearing Sciences, Bondurant Hall, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Sharon_Williams@unc.edu
Sharon Wallace
SW
Williams
Christianna S
CS
Williams
Sheryl
S
Zimmerman
Jean
J
Munn
Debra
D
Dobbs
Philip D
PD
Sloane
D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data*; D003072:Cognition Disorders / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D010809:Physical Fitness; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000706:statistics & numerical data*