The impact of hospice services on the quality of life of primary caregivers.

PURPOSE/OBJECTIVES To evaluate the effects of hospice services on the quality of life of primary caregivers and to evaluate the validity and reliability of a new tool. DESIGN Exploratory, descriptive. SETTING A nonprofit hospice in Florida; clients are cared for primarily in the home. SAMPLE 68 adult primary caregivers of 68 patients with cancer enrolled in hospice care and 62 noncaregiving adults. METHODS Subjects were recruited on admission to hospice and completed the Caregiver Quality of Life Index (CQLI) and the Hospice Quality of Life Index (HQLI) on admission and during week four of hospice care. MAIN RESEARCH VARIABLES Caregivers' assessment of their own physical, social, financial, and emotional quality of life; patients' assessment of their physical, psychological, spiritual, social, and financial well-being. FINDINGS No significant differences were found in caregiver quality-of-life scores from admission to week four, and no correlations existed between quality-of-life scores and age or education. A significant positive correlation was found between the caregivers' quality of life and their estimate of the patients' quality of life. Evidence exists that the CQLI is valid and reliable. CONCLUSIONS Caregivers of terminally ill people with cancer can maintain their quality of life during the first month of hospice care. The caregiver's perception of the patient's quality of life may affect the caregiver's quality of life. IMPLICATIONS FOR NURSING PRACTICE When offering support to primary caregivers, the hospice team should include the four domains (physical, emotional, social, and financial) and should focus on the interrelatedness of the patient's and caregiver's quality of life.