When palliative care makes stress worse

Palliative care resources may actually increase stress levels for families of patients with chronic illnesses, according to a recent study published in JAMA.

As more Americans age with chronic disease, a notably larger portion of older adults are receiving help from caregivers, who are often spouses, children or other family members. Despite this trend, taking care of family members with chronic critical illness is not easy — and can even lead to significant psychological distress. Many palliative care clinicians try to meet caregivers' needs by leading informational and emotional support meetings.

The team of researchers behind thestudy set out to determine how effective those support meetings are in improving family anxiety, depression and post-traumatic stress disorder. Through a randomized clinical trial conducted from 2010 to 2014 across four intensive care units, researchers compared the outcomes between families who received palliative care support to those who received routine support from ICU teams.

After three months of counseling, they found no significant difference in anxiety and depression between families in each of the programs. They did find families in the palliative care support group actually had more symptoms of post-traumatic stress disorder, compared to families who received routine support.

"These findings do not support routine or mandatory palliative care-led discussions of goals of care for all families of patients with chronic critical illness," the authors concluded.


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