Hospice Use and Spiritual Support for Family and Friend Caregivers at the End of Life and During Bereavement

Abstract

Context

As family and friend caregivers navigate care recipients’ end of life and death, they may benefit from spiritual support. Hospice care typically includes access to chaplain care and grief support. However, this connection is underexplored.

Methods

Our cross-sectional observational study examined bereaved caregivers’ responses to a one-time survey module added during the 2023 wave of the Care Network Connections over Time study, a nationally representative longitudinal survey of family and friend caregivers helping adults 50 and older. We examined hospice use among care recipients and its relationship to spiritual support for caregivers.

Results

Among the 315 caregiving dyads, 61% (n = 193) of care recipients were on hospice at time of death. Controlling for sociodemographic and contextual characteristics, caregivers of care recipients on hospice were more likely than those not on hospice to both want (OR = 2.66, P = .02) and receive (OR = 2.57, P = .04) spiritual support while caregiving. Caregivers belonging to a religious tradition were more likely to want and receive spiritual support than nonreligious caregivers. Evangelical Protestants wanted support more often than other religious groups in bereavement and more than Catholic/Orthodox caregivers while caregiving. The type of spiritual support received varied by religious affiliation (eg, Catholic/Orthodox caregivers were more likely than others to receive support through rituals and sacraments). During bereavement, caregivers’ desire for and receipt of spiritual support were not significantly associated with care recipients’ hospice use.

Conclusion

Hospice is an important determinant of caregivers’ spiritual support. Hospice is a key resource for promoting wellbeing during end-of-life caregiving but not into bereavement.