Carers’ Experiences of End‐of‐Life Care: A Scoping Review and Application of Personal Construct Psychology

Abstract

Objective Individuals who care for a family member or friend at end‐of‐life experience a range of practical and emotional challenges. This paper applies a theoretical framework of personal construct psychology (PCP) to explore carers’ experiences of end‐of‐life care, with a focus on implications for their sense of identity. Method Literature searches were conducted through PsycINFO, Medline, PubMed, and Google Scholar for articles published since 2005 with a focus on carer experiences at end‐of‐life. Main themes identified through this literature review were considered in light of PCP theory, with particular attention on the notion of “threat” (i.e., an imminent and comprehensive change in a person's core identity structure). Implications were then drawn for providing practical carer support. Results The reviewed literature highlighted carers’ practical challenges at end‐of‐life (e.g., assisting with activities of daily living), emotional challenges (e.g., negotiating the imminent death of a family member or friend), and personal implications (e.g., sudden removal of caring responsibilities). Conclusions The constructivist notion of “threat” is a particularly salient concept for end‐of‐life carers as they negotiate the approaching death of a family member or friend. This can have significant ramifications for their sense of identity beyond bereavement. Clinical approaches based on PCP may effectively support end‐of‐life carers to develop identities beyond their caring role as they transition to a life without caring responsibilities.

Psychosocial Interventions for End‐of‐Life Care: An Invited Commentary

“…Broady () explored carers' experiences of end‐of‐life care in a narrative literature review. Broady (2017) applied personal construct psychology (PCP) to explore alternative ways that carers can view their caring roles.…”

“…Broady (2017) applied personal construct psychology (PCP) to explore alternative ways that carers can view their caring roles. PCP advocates the use of a range of different interventions and strategies including “Fixed Role therapy,” Ravennette's “Who Are You?” Interview, narrative therapy, and art therapy (Broady, ). Although these interventions require further exploration, they may assist with deconstructing the death and dying process and could potentially help normalise bereavement and end‐of‐life issues and empower carers to maintain a self‐identity throughout the caring role.…”

“…This paper illustrates that psychologists are an underutilised resource in clinical service provision and further integration of psychologists into end-of-life care could be beneficial. Broady (2017) explored carers' experiences of end-of-life care in a narrative literature review. Broady (2017) applied personal construct psychology (PCP) to explore alternative ways that carers can view their caring roles.…”

“…Broady (2017) explored carers' experiences of end-of-life care in a narrative literature review. Broady (2017) applied personal construct psychology (PCP) to explore alternative ways that carers can view their caring roles. PCP advocates the use of a range of different interventions and strategies including "Fixed Role therapy," Ravennette's "Who Are You?"…”

Psychology and End of Life: Australian Psychologist

“…In this issue, five interrelated articles present data on different aspects of caring for people at the end of life. These articles explore the needs and challenges faced by caregivers experiencing complex grief (Klasen, Bhar, Ugalde, & Hall, ); parents with incurable cancer who have children under the age of 18 (Steiner, Shlonsky, & Joubert, ); and patients and caregivers struggling with issues of personal identity (Bentley, O'Connor, Shaw, & Breen, ; Broady, ; Leonard, Horsfall, Noonan, & Rosenberg, ).…”