What is the role of friends when contributing care at the end of life? Findings from an Australian population study

Purpose: To examine the role of friends as caregivers of people with terminal illness. Method: Piloted questions were included in the 2001-2007 random face-to-face annual health surveys of 23 588 South Australians on the death of a loved one, caregiving provided, and characteristics of the caregiver and deceased individual. The survey was representative of the population by age, gender, and region of residence. Analyses focused on friends of the deceased loved one, providing daily or intermittent 'hands on' care. Logistic regression assessed predictors of home death. Results: Daily 'hands on' carers were much more likely to be female and aged between 55 and 64; there was also a younger (< age 45) cohort of intermittent 'hands on' caregivers. When friends were carers, the deceased was more frequently younger (< age 65) and had cancer (p <= 0.001). Almost a third of caregiving friends were actively involved in care for > 12 months. Home deaths were more frequent (32%, p = 0.014) when friends were carers, and the rate of palliative care use was higher than when family/others provided care (70 vs 61%). Regression analyses confirmed friends as caregivers as a predictor of home death (OR 1.73: 95%, CI 1.15-2.87). Conclusion: Friends contribute their caregiving: A cohort of younger caregivers may reflect changing social mores as the extended family shrinks and people turn to friendship networks for care and support at the end of life. Copyright (C) 2010 John Wiley & Sons, Ltd.