Working with ambivalence: informal caregivers of patients at the end of life

Informal caregivers of patients at the end of life perform a crucial role i n maintaining and supporting patients at home. They provide a high level of demanding care, and as a consequence have been shown to have high-level in formation and support needs themselves. However, they are less often identi fied as recipients of services than as providers, and little research has a ddressed how services should be developed to meet their needs. This study a imed to address obstacles in the access to and provision of targeted, appro priate interventions. Eighteen informal carers participated in this qualita tive study, which used a grounded approach to the analysis and generation o f concepts. The data showed that while recognising their stress, anxiety an d need for a caregivers' service, caregivers were highly ambivalent with re gard to their own needs. The design and delivery of an intervention aimed a t caregivers should take account of their high level of ambivalence by addr essing their lack of identification with their role, enhancing existing cop ing strategies, and ensuring that interventions are accessible and acceptab le.