Family caregivers bring patients near the end of life to the hospital, often with the expectation that hospital care can "fix" their family member's health. Bringing up issues of the end of life can elicit a very negative reaction, and this (naturally) leads many hospital staff to avoid the topic.
This negative reaction can be based on expectations - if no one has clearly explained the typical disease course, then why would a family caregiver or patient expect anything but recovery, or at least improvement? This misconception is often reinforced by how patients leave the hospital: sent to a facility for rehabilitation, or home with a physical therapist. Unless it is made clear to the family that the rehab services are for maximizing or maintaining function and comfort, and not for "recovery," then the patient and family have no understanding of the situation, and cannot plan or adjust.
For many families, one of the options near the end of life is hospice. But how to talk with family caregivers about hospice? Hospice can have a huge impact not just on your patient, but also on the family caregiver. The Guide to Hospice and Palliative Care can help you to talk with families about end of life options and to plan ahead. This guide includes hospice services, what makes hospice different from palliative care, and payment.
For patients who have been independent until very recently, the transition to end-of-life care can be a shock for all involved. Up until this crisis, the patient's family members were simply spouses, children, or friends of the patient, and not "family caregivers." The guide The First Step in Care: Becoming a Family Caregiver can assist you in preparing them for this crucial change in role, including what it can mean for them when caregiving ends. The guide to assessing family caregiver needs can be of good use at this time as well.