Differential Effects of an Integrated Community-Based End-Of-Life Support Team (ICEST) Model for Terminally Ill Older Adults on Spousal and Adult-Children Caregivers.

The study used a pre-post design rather than a randomised trial because of ethical considerations, so it did not compare caregivers who received the model with caregivers who did not. Only 251 of 628 enrolled family caregivers completed both baseline and three-month assessments, and the analysis included only completed cases. Completers and dropouts differed in education level. Three-month assessment was not applicable if the patient died before that point, so the outcomes were measured only before death. Participation was voluntary, and caregivers tended to have intimate relationships with, or a strong willingness to care for, the terminally ill family member. All participants were Chinese, so the findings may not generalise to other cultures or contexts. The intervention combined doctors, nurses, social workers, personal care workers, volunteers, assessment planning, psychoeducation, counseling, caregiving skill training, family communication, conferences and activities, so the contribution of any single component cannot be separated.

The authors declared no potential conflicts of interest. The Hong Kong Jockey Club Charities Trust initiated and funded the JCECC project and also funded the evaluation of the ICEST model.

Do not read the improvements as proof that the ICEST model, or any single part of it, caused them. The study had no comparison group, only 251 of 628 caregivers completed both assessments, and the support was delivered as a team bundle including doctors, nurses, social workers, personal care workers, volunteers, assessment planning, psychoeducation, counseling, caregiving skill training, family communication, conferences and activities. The contribution of any component cannot be separated.