The experience of family caregivers when their loved one is home hospitalized: a mixed methods analysis of a randomized controlled trial.

In 30 seconds

This mixed-methods analysis examined family caregivers of patients in a multicentre randomised controlled trial of rural home hospital care in the USA and Canada. Caregiver burden was measured before and after care using the ZBI-12, with comparisons between home hospital and brick-and-mortar hospitalisation; home hospital caregivers also completed qualitative interviews. Median burden scores did not differ significantly between groups at admission, discharge, or in change from admission to discharge. Interviews identified positive experiences linked to communication and shared decisions, perceived care quality, and flexibility, comfort, and psychosocial support.

Key findings

• Median ZBI-12 burden change was 0 [-2.5 to 3] for home hospital caregivers versus 1.5 [0-3.5] for brick-and-mortar caregivers (P = .269).
• Burden scores did not differ significantly between groups at admission (P = .723) or discharge (P = .309).
• Interviews identified strong communication and shared decision-making as factors shaping caregivers’ positive experiences.
• Caregivers described home hospital as offering patient-centred care, flexibility, comfort, and psychosocial support.

Why it matters

Caregiver involvement is integral to delivering hospital-level care at home, so caregiver burden and experience are important dimensions alongside patient outcomes. These findings suggest that, in this rural trial, home hospital was not associated with greater measured burden and was viewed positively by interviewed caregivers. They also highlight communication and shared decision-making as relevant features of the caregiving experience.

What to keep in mind

The caregiver burden comparison involved small groups (20 home hospital and 10 brick-and-mortar caregivers), and qualitative interviews were conducted only with home hospital caregivers.