title: Exploring factors that influence informal caregiving in medication management for home hospice patients.
abstract: OBJECTIVE
  To explore factors that influence how informal caregivers manage medications as part of caring for hospice patients.
  
  
  METHODS
  Semistructured, open-ended interviews were conducted with 23 informal caregivers and 22 hospice providers from 4 hospice programs in the Chicago metropolitan areas. Qualitative analysis was conducted consistent with the grounded theory approach.
  
  
  RESULTS
  In general, informal caregivers and hospice providers identified similar key factors that facilitated or impeded caregivers' process in managing medications. Caregivers' life experience and self-confidence were considered assets that facilitated medication management. Limitations impeding the process included caregivers' negative emotional states, cognitive and physical impairments, low literacy, other competing responsibilities, as well as patients' negative emotional states and complex medication needs. Furthermore, the social context of medication management emerged as a salient theme: caregivers' good interpersonal relations with patients facilitated medication management, whereas poor communication/relations among caregivers within a support network impeded the process. While both study groups discussed the positive attributes of good caregiver-patient relations and support from multiple caregivers, hospice providers were cautious about the potential adverse influence of close relations with patients on caregivers' decision making about medications and discussed poor communication/relations among informal and privately hired caregivers that often resulted from family conflicts and/or a lack of long-standing leadership.
  
  
  CONCLUSIONS
  Our findings suggest additional intervention points, beyond knowledge and skill building, that could be addressed to support caregivers in executing medication responsibilities at home for hospice patients.
authors.affiliation: Buehler Center on Aging, Health & Society, Northwestern University, Chicago, Illinois 60611, USA. DenysTLau@yahoo.com
authors.forename: Denys T
authors.initials: DT
authors.lastname: Lau
authors.forename: Rebecca
authors.initials: R
authors.lastname: Berman
authors.forename: Leslie
authors.initials: L
authors.lastname: Halpern
authors.forename: A Simon
authors.initials: AS
authors.lastname: Pickard
authors.forename: Robert
authors.initials: R
authors.lastname: Schrauf
authors.forename: Whitney
authors.initials: W
authors.lastname: Witt
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology*; D002641:Chicago; D003657:Decision Making; D004358:Drug Therapy / Q000451:nursing*; D005260:Female; D006701:Home Nursing / Q000523:psychology*; D017051:Hospice Care / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research