title: Facilitating change and adaptation: the experiences of current and bereaved carers of patients with severe chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Patients with severe chronic obstructive pulmonary disease (COPD) experience substantial symptom burden, psychological and social morbidity. The experience of this illness has an impact beyond the patient.
  
  
  OBJECTIVE
  This study seeks to understand the experiences and needs of family carers of people with severe COPD.
  
  
  METHODS
  Semistructured interviews were held with current and bereaved carers of people with severe COPD. Several areas of content were targeted in the interviews, including the experience of caring for someone with COPD, views of treatment and prognosis, information and communication needs, and the understanding of palliative care. Data were analyzed thematically.
  
  
  RESULTS
  The carers' and bereaved carers' experiences and needs around COPD are best understood as a dynamic of change, recognition, and adaptation. Carers faced many changes as the patients' general condition deteriorated. These were changes in the nature of caring tasks, in their relationships, and their own expectations. Carers usually recognized change had happened and sought to adapt through new approaches, new equipment, a new stance of thinking, and in most cases, continued caring. Within this theme of change, recognition, and adaptation were a series of subthemes: (1) the impact of caring, (2) recognizing the role of the carer, and (3) the needs of the carer including their needs from palliative care services.
  
  
  CONCLUSIONS
  The impact of caring borne by family carers is substantial and life changing. Health professionals may assist carers in their role through acknowledgement, facilitating recognition of the changes that have occurred (and their implications), and enabling creative adaptive responses for carers. Such assistance is likely to enhance the ability of carers to continue in this demanding role.
authors: 1 Palliative Care Service, St. Vincent's Hospital , Fitzroy, Australia .
authors: Jennifer
authors: J
authors: Philip
authors: Michelle
authors: M
authors: Gold
authors: Caroline
authors: C
authors: Brand
authors: Belinda
authors: B
authors: Miller
authors: Jo
authors: J
authors: Douglass
authors: Vijaya
authors: V
authors: Sundararajan
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001601:Bereavement; D017028:Caregivers / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D013315:Stress, Psychological / Q000523:psychology