title: Exploring the financial impact of caring for family members receiving palliative and end-of-life care: a systematic review of the literature.
abstract: BACKGROUND
  Research regarding the economic dimensions of palliative care is relatively limited. The economic implications of providing informal care are well recognised; however, within the context of palliative care, little is known about the costs and implications of providing care for a loved one at the end of life.
  
  
  OBJECTIVE
  To explore the financial costs and the financial impact of caring for family members receiving palliative/end-of-life care.
  
  
  METHODS
  A systematic literature review of empirical research following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
  
  
  METHODS
  Seven electronic databases were searched from inception to April 2012. Inclusion criteria were as follows: articles relating to the financial costs or implications of family caregiving at the end-of-life care, English language articles, empirical research or systematic reviews and articles relating to adults.
  
  
  RESULTS
  The review identified 21 relevant articles; however, evidence relating to the costs and implications of caregiving was relatively limited. The results indicate that the financial costs of caring for someone at the end of life are substantial. Financial costs can result in significant and multidimensional caregiver burden. Various factors were found to mediate the extent of financial burden.
  
  
  CONCLUSIONS
  This review identified a significant gap in the evidence base regarding the economic implications of providing care to a family member within a palliative care context. Economic costs and implications are likely to be significant, and research to address this gap is urgently needed, particularly given policy initiatives in a number of developed countries to move the provision of palliative and end-of-life care from hospital to community settings.
authors.affiliation: 1School of Nursing, The University of Auckland, Auckland, New Zealand.
authors.forename: Clare
authors.initials: C
authors.lastname: Gardiner
authors.forename: Louise
authors.initials: L
authors.lastname: Brereton
authors.forename: Rosemary
authors.initials: R
authors.lastname: Frey
authors.forename: Laura
authors.initials: L
authors.lastname: Wilkinson-Meyers
authors.forename: Merryn
authors.initials: M
authors.lastname: Gott
mesh_terms: D017028:Caregivers / Q000191:economics*; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D005190:Family; D006801:Humans; D010166:Palliative Care / Q000191:economics*; D013727:Terminal Care / Q000191:economics*
keywords: Palliative care; economic impact; family caregiver; financial impact; informal carer