title: Exploring the collective hospice caregiving experience.
abstract: BACKGROUND
  Collective caregiving, performed by caregivers working in pairs (informal primary and secondary caregivers working together), is common in the hospice setting. Research suggests that caregiving pairs may experience different caregiver outcomes. However, little is known about how caregiving pairs differ from solo caregivers (informal primary caregivers) on outcome measures.
  
  
  OBJECTIVE
  The goal of this study was to determine whether being in a caregiver pair affected caregiver anxiety and depression and how outcomes changed over time.
  
  
  METHODS
  A mixed model analysis was used.
  
  
  METHODS
  Hospice caregivers (260 solo caregivers and 44 caregivers in 22 pairs) who participated in a larger, randomized controlled trial completed caregiver measures upon hospice admission and periodically until the death of the patient or hospice decertification.
  
  
  METHODS
  Measured were caregiver quality of life, social support, anxiety, and depression.
  
  
  RESULTS
  Caregiver pairs had higher anxiety and depression scores than solo caregivers. Emotional, financial, and physical quality of life were associated with decreased depression, whereas only emotional and financial quality of life were correlated with lower levels of anxiety. Social support was associated with lower levels of depression and anxiety.
  
  
  CONCLUSIONS
  Despite assumptions that social support is positively facilitated vis-a-vis collective caregiving, caregiving pairs may be at higher risk for anxiety and depression. Future research is needed to address why individuals become anxious and/or depressed when working as part of a caregiving pair.
authors.affiliation: 1 Division of Nursing Research and Education , City of Hope, Duarte, California.
authors.forename: Elaine
authors.initials: E
authors.lastname: Wittenberg-Lyles
authors.forename: Robin L
authors.initials: RL
authors.lastname: Kruse
authors.forename: Debra Parker
authors.initials: DP
authors.lastname: Oliver
authors.forename: George
authors.initials: G
authors.lastname: Demiris
authors.forename: Greg
authors.initials: G
authors.lastname: Petroski
mesh_terms: D000328:Adult; D017028:Caregivers / Q000523:psychology*; D034462:Dissent and Disputes; D005195:Family Relations; D005260:Female; D017051:Hospice Care / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011368:Professional-Family Relations; D011788:Quality of Life; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D055815:Young Adult