How Hospice, Behavioral Health Can Team Up for Caregiver Support

Forging stronger interdisciplinary relationships with behavioral health experts could help hospice providers ease caregiver burdens that can impact quality of end-of-life care.

A growing aging population is putting pressure on today’s family caregivers with competing priorities. Now more than ever adults in the United States are increasingly struggling to balance work, family and caregiver roles amid rising demand for serious illness and end-of-life care, according to Melissa Reilly, chief growth officer at Evernorth Behavioral Health.

Caregivers can often have unmet mental health needs that significantly impact their ability to support critically ill loved ones – an area that more health care providers will need to focus on addressing to improve quality, Reilly said at Aging Media Network’s Continuum conference in Washington, D.C.

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“We are officially living in that sandwich generation where so many of us actually are caregivers, taking care of our children, sometimes even the parent is now taking care of two generations,” Reilly said. “What we’ve seen in our data is that the mental health of the caregiver drastically impacts the mental health needs of the patient. We’re finding that those that are taking care of someone else, their mental needs end up down here, and then they’re actually ineffective to be able to help take care of that patient.”

Some hospices have increasingly ramped up caregiver support, including expanded respite care services, providing connective resources for financial and practical assistance, and holding community groups for caregivers to share their experiences.

But many caregivers lack a safe space to discuss the hardships of caring for a seriously or terminally ill family member, according to Reilly. Additionally, overburdened caregivers often aren’t aware of the mental health resources available to them or how to get connected with them, she stated. 

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Melissa Reilly Merz Photography / Hospice News
Melissa Reilly, chief growth officer, Evernorth Behavioral Health, at the CONTINUUM Conference. Photo by Merz Photography.

More coordination is needed among hospice and behavioral health providers to improve caregiver support and the impacts on patient experiences, Reilly said.

“The biggest challenge that we continue to face is actually activating people into that care continuum,” Reilly said. “We’re expecting people to be able to navigate through a fragmented health care system and actually get the care that they need to maybe not get better in this circumstance, but at least be able to live functionally in whatever life you choose to desire. There are many barriers that we’re facing right now that would actually allow people to address our mental needs optimally.”

The strain on caregivers could mean that ultimately fewer patients will be able to receive hospice care in their homes.

Improving access and quality disparities for terminally ill patients includes addressing unpaid caregiver needs, according to Lisa Hogan, assistant vice president of operations at Unity Psychiatric Care. Caregivers can face high levels of burnout that need a multifaceted care delivery approach – one that includes mental health support, she indicated.

Involving behavioral health experts in interdisciplinary team meetings can help hospices better understand the issues among caregivers and how they collaborate to address and meet them, Hogan said. Without greater mental health support for caregivers, access, utilization and quality of end-of-life care can be impacted, she said.

“It’s very important for seniors to get the appropriate care they need,” Hogan said at the conference. “Sometimes the caregivers are so exhausted and they mentally have not addressed issues that they [may] have. So they’re not functioning at capacity. It’s super important that we follow up, that we do patient education and family education and provide community events.”

Lisa Hogan Merz Photography / Hospice News
Lisa Hogan, assistant vice president of operations, Unity Psychiatric Care, at the CONTINUUM Conference. Photo by Merz Photography.

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