From neighbour to carer: An exploratory study on the role of non-kin-carers in end-of-life care at home for older people living alone.

BACKGROUND

A growing number of older people are living in single households. They form a disadvantaged group within society as regards staying at home, most likely towards the end-of-life. It is mainly non-kin-carers who try to fulfil older people's desire for a home death, but very little is known about the challenges they face during their involvement.

AIM: Getting insight into the engagement of non-kin-carers in the support for older people living alone, and a better understanding of the challenges they have to manage in end-of-life care.

DESIGN

Exploratory qualitative design; perspectives of non-kin-carers were collected through personal in-depth interviews ( n = 15) retrospectively.

SETTING

Home care, urban and rural areas in Austria Findings: A slow and subtle transition into care is what characterizes non-kin-care relationships which show differences between friends and neighbours. Towards the end of life, the main challenges emerged around increased physical care needs, issues of decision-making and facing the process of dying. Prior experiences with the latter, which most of the involved carers had, influenced non-kin-carers' steadiness to allow home death and so did reliable formal support, particularly from specialized palliative care teams.

CONCLUSION

Support of older people living alone, in particular until the last stage of life, comes along with multiple efforts. Respectful and supporting relationships between professional carers and non-kin-carers are vital to keep non-kin-carers involved.