{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T09:45:08Z","timestamp":1788860708337,"version":"build-2803163510"},"reference-count":38,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"unspecified","delay-in-days":247,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S1478951525100205_sec1a\">\n\t    <jats:title>Objectives<\/jats:title>\n\t    <jats:p>Family caregivers (FCGs) may experience numerous psychosocial and practical challenges with interpersonal relationships, mental health, and finances both before and after their care recipient (CR) dies. The specific challenges affecting rural FCGs who often have limited access to palliative care services, transitional care, and other community resources are not well understood. The purpose of this paper is to quantify the challenges rural FCGs experienced immediately before the death of a CR and continuing into the bereavement period.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951525100205_sec2b\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>A secondary analysis of data from a randomized controlled trial was conducted. The 8-week intervention included video visits between a palliative care research nurse and FCGs caring for someone with a life-limiting illness. Data were from structured interviews during nurse visits with FCGs in the intervention arm whose CR died during the intervention period.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951525100205_sec3c\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Ninety (41.8%) of the 215 FCGs experienced the death of their CR. The majority of FCGs were female (58.9%), White (97.5%), spouses or partners (55.6%) and lived with the CR (66.7%). Most FCGs (84%) continued with intervention visits by the study nurse after the CR\u2019s death. Visits resumed on average 7.2 days post-death. The majority of FCGs experienced challenges with grief\/coping skills (56%) and interpersonal relationships\/support systems (52%) both pre- and post-death of the CR. FCGs also experienced practical challenges with income\/finance, housing, and communication with community resources both pre-and post-death.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951525100205_sec4d\">\n\t    <jats:title>Significance of results<\/jats:title>\n\t    <jats:p>Bereavement support should extend beyond a focus on grief to include practical challenges experienced by FCGs. Because challenges experienced in the bereavement period often begin before a CR\u2019s death, there is benefit in continuity of FCG support provided by a known clinician from pre- to post-death. When given an option, many rural FCGs are open to bereavement support as early as a week after the death of a CR.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s1478951525100205","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T10:04:13Z","timestamp":1757066653000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Beyond grief: Quantifying bereavement needs of rural family caregivers"],"prefix":"10.1017","volume":"23","author":[{"given":"Catherine","family":"Vanderboom","sequence":"first","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Holland","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cory","family":"Ingram","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brystana G.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine"},{"name":"Duke University"},{"name":"Durham Veterans Affairs Health Care System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Gustavson","sequence":"additional","affiliation":[{"name":"Minneapolis Veterans Affairs Health Care System"},{"name":"University of Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Mandrekar","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann Marie","family":"Dose","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Wild","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Stiles","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8120-3229","authenticated-orcid":false,"given":"Joan M.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Mayo Clinic"},{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"S1478951525100205_ref35","doi-asserted-by":"publisher","DOI":"10.1177\/0030222820966928"},{"key":"S1478951525100205_ref32","doi-asserted-by":"publisher","DOI":"10.1177\/26323524211032984"},{"key":"S1478951525100205_ref4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0184750"},{"key":"S1478951525100205_ref11","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16778"},{"key":"S1478951525100205_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2016.01.002"},{"key":"S1478951525100205_ref38","first-page":"21","volume-title":"Integrated Care for Older People: Guidelines on Community-Level Interventions to Manage Declines in Intrinsic Capacity","year":"2017"},{"key":"S1478951525100205_ref15","doi-asserted-by":"publisher","DOI":"10.1097\/NCM.0000000000000485"},{"key":"S1478951525100205_ref5","doi-asserted-by":"publisher","DOI":"10.1097\/NJH.0000000000000696"},{"key":"S1478951525100205_ref28","doi-asserted-by":"publisher","DOI":"10.1080\/15524256.2020.1776195"},{"key":"S1478951525100205_ref3","doi-asserted-by":"publisher","DOI":"10.1177\/0269216318774995"},{"key":"S1478951525100205_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2021.113916"},{"key":"S1478951525100205_ref10","doi-asserted-by":"publisher","DOI":"10.1177\/07334648221137882"},{"key":"S1478951525100205_ref9","doi-asserted-by":"publisher","DOI":"10.1177\/1049909118812025"},{"key":"S1478951525100205_ref13","doi-asserted-by":"publisher","DOI":"10.1177\/02692163211043372"},{"key":"S1478951525100205_ref31","volume-title":"National Strategy to Support Family Caregivers","year":"2022"},{"key":"S1478951525100205_ref16","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-020-04806-0"},{"key":"S1478951525100205_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2023.107654"},{"key":"S1478951525100205_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2022.115630"},{"key":"S1478951525100205_ref34","doi-asserted-by":"publisher","DOI":"10.1177\/08258597211052269"},{"key":"S1478951525100205_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114240"},{"key":"S1478951525100205_ref7","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.2637"},{"key":"S1478951525100205_ref1","unstructured":"Agency for Healthcare Research and Quality (2021) Chartbook on Rural Healthcare. https:\/\/www.ahrq.gov\/research\/findings\/nhqrdr\/chartbooks\/ruralhealth\/index.html (accessed 26 September 2024 )"},{"key":"S1478951525100205_ref6","unstructured":"Center for Medicare and Medicaid Services Manual System (2011) Pub 100-02 Medicare Benefit Policy: new Hospice Certification Requirements and Revised Conditions of Participation (CoPs). https:\/\/www.cms.gov\/regulations-and-guidance\/guidance\/transmittals\/downloads\/r141bp.pdf (accessed 17 July, 2024 )."},{"key":"S1478951525100205_ref18","unstructured":"Hospiscare (n.d.) Secondary grief: the domino effect of losing a loved one. https:\/\/www.hospiscare.co.uk\/how-we-help\/advice-support\/information-about-grief\/secondary-grief-the-domino-effect-of-losing-a-loved-one\/#:\u223c:text=The%20death%20of%20a%20loved%20one%20may%20result%20in%20secondary,and%20loss%20of%20financial%20security (accessed 26 September 2024 )"},{"key":"S1478951525100205_ref14","doi-asserted-by":"publisher","DOI":"10.1097\/NCM.0000000000000233"},{"key":"S1478951525100205_ref24","first-page":"519","article-title":"Caregiver engagement enhances outcomes among randomized control trials of transitional care interventions: a systematic review and meta-analysis","volume":"60","author":"Levoy","year":"2022","journal-title":"\u201cMedical Care\u201d"},{"key":"S1478951525100205_ref29","first-page":"110","article-title":"Condition of participation: hospices that provide inpatient care directly","volume":"42","year":"2023","journal-title":"US Department of Health and Human Services"},{"key":"S1478951525100205_ref33","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-013-0406-z"},{"key":"S1478951525100205_ref36","doi-asserted-by":"publisher","DOI":"10.1080\/15524256.2015.1108896"},{"key":"S1478951525100205_ref23","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnz011"},{"key":"S1478951525100205_ref19","doi-asserted-by":"publisher","DOI":"10.1089\/109662104322737214"},{"key":"S1478951525100205_ref21","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951517000475"},{"key":"S1478951525100205_ref26","doi-asserted-by":"publisher","DOI":"10.1177\/02692163211070228"},{"key":"S1478951525100205_ref25","first-page":"52","article-title":"The Omaha System and meaningful use: applications for practice, education, and research","volume":"29","author":"Martin","year":"2011","journal-title":"CIN: Computers, Informatics, Nursing"},{"key":"S1478951525100205_ref2","doi-asserted-by":"publisher","DOI":"10.1080\/07481187.2019.1648331"},{"key":"S1478951525100205_ref17","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-017-0231-y"},{"key":"S1478951525100205_ref20","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-019-0401-1"},{"key":"S1478951525100205_ref12","doi-asserted-by":"publisher","DOI":"10.1002\/pon.6031"}],"container-title":["Palliative and Supportive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1478951525100205","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T10:04:20Z","timestamp":1757066660000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1478951525100205\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":38,"alternative-id":["S1478951525100205"],"URL":"https:\/\/doi.org\/10.1017\/s1478951525100205","relation":{},"ISSN":["1478-9515","1478-9523"],"issn-type":[{"value":"1478-9515","type":"print"},{"value":"1478-9523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"\u00a9 United States Department of Veteran Affairs and Mayo Clinic, 2025. To the extent this is a work of the US Government, it is not subject to copyright protection within the United States. Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e157"}}