DEVELOPING A SUPPORT AND BEREAVEMENT BUNDLE FOR INFORMAL CAREGIVERS OF PATIENTS WITH A VENTRICULAR ASSIST DEVICE-DESTINATION THERAPY

Abstract

Heart Failure (HF) is a leading cause of mortality globally, posing significant challenges in healthcare, especially in older adults. This review explores the multifaceted impacts of ventricular assist devices (VAD) as a treatment option. The prevalence of HF and the adoption of VADs vary significantly across regions, with countries like Lebanon facing unique challenges. VADs initially used as a bridge to heart transplantation, have shifted into a long-term solution for many patients, including those ineligibles for transplant. This shift has profound implications for patient care and caregiver burden, that may affect the negatively.

The economic burden of VADs is substantial, with costs encompassing device implantation, hospitalization, and ongoing care. Caregivers of VAD patients face significant psychological and emotional stress, often leading to anxiety, depression, and socioeconomic strain. In Lebanon, the scarcity of organ donations and the high cost of VADs present additional challenges. This review also delves into the complexities of end-of-life care for VAD patients’ caregivers, underscoring the need for advanced care planning and bereavement support.

Guidelines have highlighted the importance of support and bereavement programs for VAD caregivers, as early as the decision of implantation is made, however, none of the hospitals in Lebanon have adopted one. This documents proposes a support and bereavement intervention checklist for informal caregivers, addressing the gap in the Lebanese context. By integrating cultural values and healthcare policies, the study seeks to improve the overall experience of patients and their caregivers, especially during bereavement.