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Family Caregivers' Heavy and Overloaded Burden in Advanced Chronic Obstructive Pulmonary Disease.

BACKGROUND
Due to severe symptoms and poor prognosis in advanced cases, chronic obstructive pulmonary disease (COPD) is today seen as a palliative diagnosis. The everyday lives of patients as well as their relatives are restricted and affected by significant psychosocial problems.


OBJECTIVE
To obtain detailed knowledge about people's experiences, for example, transitions in relationships, responsibility, and possible changes in communication, caused by the illness.


DESIGN
This is a qualitative interview study using both focus group interviews and individual interviews.


SETTING/SUBJECTS
In total, 35 family members with personal experience of living with a person with severe COPD were interviewed.


MEASUREMENTS
The semistructured interviews were audio-recorded, transcribed verbatim, and analyzed with a qualitative content analysis.


RESULTS
Three themes emerged: (1) A restricted everyday life. The family caregivers felt confined to their own home, they had to be constantly attentive, and their lives became increasingly restricted. (2) A changed relationship. There was a shift in responsibility and their mutual communication. The family caregivers' own needs were neglected and the relationship was affected. (3) Joy through adaption. Still, caregivers strived for normality and, through gradual adaption, they could still experience joy.


CONCLUSIONS
Being a family caregiver is a burdensome and complex situation. Besides providing practical help, the family caregiver needs to support the ill person. Roles and communication patterns are changed. Healthcare staff must identify the needs of the family caregivers. A family caregiver who feels acknowledged and confident can support their severely ill family member.