title: Sadness, anxiety, and experiences with emotional support among veteran and nonveteran patients and their families at the end of life.
abstract: BACKGROUND
  Although many veterans are progressing into older adulthood and a substantive subset of people who die each year in the United States served in the military, there is limited evidence on the role of military service at the end of life.
  
  
  OBJECTIVE
  The objective of the study was to examine differences in caregivers' perceptions of sadness and anxiety at the end of life between veteran and nonveteran patients and levels of contentment with the emotional support provided to the patient and family by hospice staff.
  
  
  METHODS
  This cross-sectional study used clinical information from the Family Evaluation of Hospice Care (FEHC) survey administered to caregivers of a patient who received hospice services. The sample in this study included 560 individuals who completed the FEHC survey (from December 2007 to April 2013) after receiving services at a large hospice in an urban southwestern U.S. city. Caregivers responded to questions on the FEHC survey about demographic information, perceptions of the patient's level of sadness/anxiety, and the emotional support the patient and family received from hospice staff. In addition, information regarding veteran status was obtained from patients' medical records.
  
  
  RESULTS
  Caregivers of veterans were significantly more likely to report that the patient experienced sadness/anxiety at the end of life, as well as a desire for more emotional support for the family from hospice staff after the death.
  
  
  CONCLUSIONS
  Results provide preliminary evidence for veteran status being a risk factor for emotional distress at the end of life, highlighting the possible need for augmented support services for veterans and their families in hospice and palliative care.
authors.affiliation: 1 Department of Psychology, University of Nevada Las Vegas.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Holland
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Currier
authors.forename: Abbie
authors.initials: A
authors.lastname: Kirkendall
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Keene
authors.forename: Nora
authors.initials: N
authors.lastname: Luna
mesh_terms: D000368:Aged; D001007:Anxiety; D017028:Caregivers / Q000523:psychology*; D003258:Consumer Behavior; D003430:Cross-Sectional Studies; D005069:Evaluation Studies as Topic; D005190:Family / Q000523:psychology*; D006117:Grief; D017051:Hospice Care / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D012944:Social Support; D015206:Southwestern United States; D014481:United States; D014728:Veterans / Q000523:psychology*