Needs assessment of spouses caring for terminally ill mates at home: implications for nursing

A retrospective descriptive study was conducted to assess the needs of spouses caring for terminally ill mates at home. Four questions were studied: 1. What are the needs of the spouse who is providing primary care to a dying mate at home? 2. Are some of the identified needs met or partially unmet, as perceived by the spouse? 3. Will spouses classified indifferent categories have different expressed needs? 4. Will spouses classified in different categories have variant degrees of unmet needs? The instrument used in this study was a questionnaire designed by the investigator. The questionnaire dealt with five major categories of need, plus the opportunity for the spouse to add personal input. The study population consisted of a spouse taking care of the terminally ill mate at home for a minimum of four weeks. The data analysis indicated that there was a statistically significant difference between the number of hospitalizations the dying mate required three months before death, and the increased expressed needs of the care giver. There was also a significant difference between care givers who had previously taken care of a dying person at home to one who had not. The spouse with previous experience had significantly fewer expressed needs in the area of talking to others about the impending death and sequela. The category relating to the personal needs of the care giver produced the greatest degree of unmet needs. It appears that most spouses give up many personal needs to devote more time to the ill mate. A trend was also depicted that male care givers have more expressed needs than females in the area of knowing how to give physical care to the dying mate. The care giver also had the opportunity to respond to open-ended questions. The majority of spouses stated the experience was positive for them and they would care for their spouses at home again, given the opportunity. The county visiting nurse was rated most frequently as the most helpful aide to the spouse caring for a dying mate at home. The implications of these findings will assist nursing and other health care professionals provide anticipatory guidance to both the care giver and patient, thereby promoting successful home care of the terminally ill.