In the United States, the number of people older than 60 is expected to triple over the next 50 years, and as the population ages so do family caregivers. Increased levels of depression and low ratings of subjective well-being in caregivers are consistently associated with older age, the spousal relationship, and female caregiver gender. Less well known is the effect care delivery models have on the older adult as his or her spouse approaches the end of life. The purpose of this study was to explore the challenges faced by older adult spousal caregivers providing end-of-life care across different life-limiting illness trajectories in distinctive care delivery models. An instrumental case study using purposive sampling identified the following themes for older spousal caregivers: balancing multiple morbidities; feeling overwhelmed and exhausted; dealing with personal health issues; feeling isolated; and coordinating care. Implications for health care providers are also examined.
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