Family caregiver skills in medication management for hospice patients: a qualitative study to define a construct.
OBJECTIVE
To propose a theoretical construct of family caregiver skills in effective medication management for home hospice patients.


METHODS
Semistructured face-to-face interviews were conducted with 22 hospice providers (14 nurses, 4 physicians, and 4 social workers) and 23 family caregivers (10 daughters, 4 wives, 2 husbands, and 7 others) of elderly patients (>or=60 years old) who were receiving home services from four hospice care programs in the Chicago metropolitan area.


RESULTS
Although both groups identified similar skill sets, hospice providers emphasized technical skills such as administering medications, and family caregivers valued management skills such as organizing medications, coordinating with hired caregivers, and providing care to patients who resisted treatment. We defined effective medication management in hospice as caregivers' ability to effectively relieve symptoms with pharmacological interventions by successfully utilizing skills related to teamwork (coordinate with hospice providers and with other family or hired caregivers), organization (acquire, store, track, and discard medications), symptom knowledge (recognize and interpret common symptoms), medication knowledge (understand the basics of pharmacology and medication administration), and personhood (understand and respond to the patient's needs).


CONCLUSIONS
The proposed construct of medication management skills in hospice will help guide future development of training interventions and clinical assessment tools.
Lau
Denys T
DT
Buehler Center on Aging, Health & Society, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA. D-lau@northwestern.edu
Kasper
Judith D
JD
Hauser
Joshua M
JM
Berdes
Celia
C
Chang
Chih-Hung
CH
Berman
Rebecca L
RL
Masin-Peters
Jonathan
J
Paice
Judith
J
Emanuel
Linda
L
D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D017028:Caregivers / Q000523:psychology*; D002641:Chicago; D002908:Chronic Disease / Q000451:nursing* / Q000523:psychology; D003299:Cooperative Behavior; D004358:Drug Therapy / Q000451:nursing* / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006701:Home Nursing / Q000523:psychology*; D017051:Hospice Care / Q000523:psychology; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects; D010147:Pain Measurement / Q000451:nursing; D011368:Professional-Family Relations
D000701:Analgesics, Opioid; D009020:Morphine