Understanding the "circle of support" for caregivers of adults with Alzheimer's disease and related dementias following a hospice live discharge.

Hospice patients with Alzheimer's disease and related dementias (ADRD) are more likely to experience a live discharge. This places increased burden on primary caregivers who may be unprepared for this transition and are more likely to be socially isolated. This study explored primary caregivers' "Circle of Support" (CoS) and how social context influences service utilization patterns, perceived support, and experiences of care transitions following a hospice live discharge. Semi-structured interviews were conducted with 32 caregivers and analyzed using thematic analysis. Caregivers described their CoS, how their CoS functioned (or failed to function) post-hospice, and key caregiver and network attributes affecting support use. Findings show that caregivers reporting no changes in their tasks after discharge described more absent CoS functions. Experiences were also influenced by patient location of care and resources availability, suggesting opportunities for targeted interventions to improve caregivers' experiences and outcomes.