Symptom Management Assistance from Unpaid and Family Caregivers to Older Adults in the Last Month of Life (GP733)

Outcomes. 1. Know the size of the population of family caregivers experiencing difficulty in managing symptoms at the end of life 2. Know the extent to which caregivers experience difficulty in managing symptoms at the end of life 3. Describe factors associated with report of difficulty in managing symptoms at the end of life Importance. The recommendations of the federal Recognize, Assist, Include, Support and Engage Family Caregiving Advisory Council highlighted the need to support and train caregivers in symptom management at the end of life. Planning implementation of such programs requires an estimate of the size of the caregiver population experiencing difficulty managing common symptoms (e.g., pain, dyspnea, anxiety) and characterization of factors associated with difficulty in a nationally representative sample. Objective(s). Provide a population-weighted estimate of the size of caregiver population reporting difficulty in managing symptoms at the end of life and examine patient and caregiver factors associated with reports of difficulty in managing symptoms at the end of life. Method(s). We conducted a cross-sectional analysis of data from the nationally representative National Study of Caregiving III and the National Health and Aging Trends Study from 2017. We calculated a population estimate of caregivers reporting any difficulty in managing pain, dyspnea, or anxiety in the last month of life. We used bivariate and multivariable analyses to examine the association between caregiver sociodemographic characteristics, caregiving circumstances, care recipient factors, and reports of any symptom management difficulty. Results. The study sample included 254 caregivers of community-dwelling older adults in the last month of life, representing 2.3 million caregivers nationally (45.3% daughters, 15.4% spouses; 85.7% non-Hispanic White). Overall, 87.4% (2 million) caregivers provided support managing symptoms; 78% (1.6 million) reported difficulty. Of those who reported managing pain, dyspnea, and anxiety, 82.0%, 71.1%, and 88.3%, respectively, reported difficulty. In multivariable mixed effect regression models, caregiver education greater than high school and number of care recipient comorbidities were significantly associated with caregiver reports of difficulty managing symptoms. Conclusion(s). End-of-life symptom management is challenging for caregivers, with anxiety being the most challenging symptom to manage. Impact. This study reinforces the call