Prolonged mechanical ventilation and caregiver strain: Home vs. long-term care facility

Area of Science:

• Palliative Care
• Gerontology
• Health Services Research

Background:

• The number of patients requiring prolonged mechanical ventilation (PMV) is increasing.
• While traditionally managed in long-term care facilities (LTCFs), homecare is emerging as a viable alternative.
• Informal caregivers (ICGs) play a vital role, yet their experiences are understudied.

Purpose of the Study:

• To examine and compare caregiver strain among primary ICGs of PMV patients receiving care at home versus in LTCFs.
• To identify specific patterns of strain experienced by ICGs in different care settings.

Main Methods:

• An observational, cross-sectional study involving 106 ICGs and 120 PMV patients (46 homecare, 74 LTCF).
• Caregiver strain assessed using the 13-item Modified Caregiver Strain Index (Mod CSI).
• Patient symptom burden evaluated using the revised Edmonton Symptom Assessment System.

Main Results:

• Overall caregiver strain (Mod CSI) was similar between homecare and LTCF settings (14.30 vs. 13.26).
• ICGs in homecare reported significantly lower mood strain and higher burden compared to LTCF.
• Increased patient symptomatology was linked to higher total strain, mood strain, and burden strain.

Conclusions:

• Caregiver strain patterns differ based on care setting (home vs. LTCF), with distinct impacts on mood and burden.
• Understanding these differences is crucial for tailoring palliative care and support for ICGs.
• Supporting ICGs is essential, as they significantly influence care setting decisions for PMV patients.