Authors: RiYin Tay, Joyce YS Tan, Allyn YM Hum 

Published in: Journal of American Medical Directors Association, 2021 Oct 

DOI: https://doi.org/10.1016/j.jamda.2021.09.012

Summary points:

• Family caregivers of home-dwelling patients with advanced dementia experience a substantial level of caregiver burden due to the protracted and uncertain dementia disease trajectory and heavy symptom burden at the advanced stage of the condition.
• More than half of the family caregivers in our study were at risk of depression. Younger family caregivers without informal paid help, caring for clinically unstable patients with more severe neuropsychiatric symptoms experienced a heavier burden. The comprehensive support provided by a multidisciplinary home-based palliative care team could potentially mitigate family caregiver burden.
• The predictors of advanced dementia family caregiver burden intersect. To realise home death preferences, relevant stakeholders should collaborate to develop multi-dimensional initiatives that can sustain family caregivers in their care of patients at home.