Commitment to care: A grounded theory of informal hospice caregivers' development as symptom managers

Individuals receiving home-based hospice services often rely upon family members and friends to serve as informal caregivers responsible for managing the full range of emotional, psychological, spiritual, and physical symptoms. The purpose of this in-depth, grounded theory study was to develop a theoretical model of the processes by which informal hospice caregivers, who often lack formal training, acquire knowledge and skills related to symptom management. Findings indicate that, motivated by a commitment to care, caregivers seek competence in symptom management by learning/doing, consulting with professionals, and personalizing their caregiving approach. The ongoing nature of the development of symptom management knowledge and skills provides multiple opportunities for intervention by hospice social workers and other members of the interdisciplinary team.