Live Discharge from Hospice and the Grief Experience of Dementia Caregivers

• Published in: Journal of social work in end-of-life & palliative care 2016-04, Vol.12 (1-2), p.47-62
• Main Author: Wladkowski, Stephanie P.
• Format: Article
• Language: English
• Subjects: Aged; Alzheimer Disease - psychology; Caregivers; Caregivers - psychology; dementia; Dementia - nursing; Family - psychology; Female; Grief; hospice; Hospice Care - psychology; Humans; live discharge; Male; Middle Aged; Patient Discharge; Social Support; Socioeconomic Factors
• ISSN: 1552-4256; 1552-4264
• DOI: 10.1080/15524256.2016.1156600

When an individual has dementia, family members are involved in many care transitions in their roles as caregivers. One such transition is the 'live' discharge from hospice services. This occurs when an individual no longer meets eligibility criteria. This can be difficult for caregivers who have been anticipating an end to understand in the context of their grief process. This qualitative study (N = 24) explored the experience of caregivers of adults with dementia, including Alzheimer's disease, who experienced a 'live' discharge from hospice. Specifically, the experience of grief is examined. Results from this study highlight the complexity of caring for someone with a terminal disease and the grief experience in end-of-life care as caregivers struggle to understand the individual's terminal prognosis as temporary. This is further complicated for caregivers who must resume caregiving responsibilities or assume a new caregiving role after experiencing a loss of hospice services. Finally, hospice social workers are well positioned to offer emotional and other concrete support to caregivers who experience a 'live' discharge.