Editor's Introduction.

Abstract

Welcome to the new volume for 2023. In this issue, interventions to improve the lives of caregivers as they provide care to individuals near the end of life is the focus. After two reflections, in a practice concepts and innovations entry, Koufacos describes an educational intervention for stress-reduction among caregivers of Veterans with dementia. There were two aspects of the program, individual counseling provided to caregivers and group self-care webinars. The interventionist was a VA palliative care social worker and these techniques showed promising results. Further examination of this model is needed but it is something that other professionals may wish to consider to reduce caregiver stress and increase self-care among dementia caregivers. In the first of the research articles, a problem-solving intervention among family caregivers of people with cancer receiving outpatient palliative care was examined with respect to dimensions/styles of problem solving. These dimensions are described well by Bruton et al., which included positive and negative orientations and found these to have a relationship with age. Also, gender was related to differences in use of rational problem-solving style and use of negative orientation and an impulsive problem-making style. Because cancer caregivers often have to deal with many changes in care plans, these factors can and should be assessed when working with cancer caregivers in outpatient palliative care settings to determine the most effective aspects of problem solving. Next, Ullrich et al., switch us to examine inpatient palliative care. A multi-factor screening intervention was conducted among patients admitted in a specialist inpatient palliative care unit in an academic center that included self-reported distress as well as psychosocial stress and others. High levels of distress, depression and anxiety were found and those indicating a subjective need for help were also found to have received assistance, such as increased use of psychological services. Social work services increased among those screened but not at a significant level. A major barrier to completing the screening was cognitive impairment. Different methods of screening for distress and other psychosocial problems may need to be developed specifically for palliative care settings. Finally, Isler and Yildirim share their study pointing to the tremendous need for hospice care in Turkey which is currently absent. Although some palliative care units exist, the needs of the country are not being met. In a qualitative approach, both oncology healthcare professionals and family caregivers of individuals near the end of life (without hospice services) were interviewed. Themes centered around preferences for environment of death, problems caused by in-hospital deaths, need for hospice care, and hospice care for caregivers. These themes were shared by the healthcare professionals and the caregivers. For individuals with cancer and their caregivers,