“I’m Having the Worst Time”

OBJECTIVE: This qualitative study aimed to explore the experiences of informal caregivers of adults aged ≥65 years who underwent major elective surgery. SUMMARY BACKGROUND: Older adults are at high risk for complications and functional decline after surgery, leading to increased care needs often met by family and friends as unpaid "informal caregivers. Little is known about caregiver experiences supporting older adults across a range of major surgeries. METHODS: Semi-structured interviews were conducted at three intervals: two weeks prior to surgery, and one-month and three months post-surgery. Participants included informal caregivers of adults aged ≥ 65 years who underwent major elective surgery at one academic hospital. The data were analyzed using inductive thematic analysis. RESULTS: Thirteen caregivers (mean age, 67, range 44-79) completed 27 interviews. Of these, 67% self- identified as white and 61% were female spousal caregivers. Themes based on interviews revealed: (1) the caregiving role evolved to become all-consuming across the continuum of perioperative care, (2) perioperative caregiving demands placed an increased strain on the caregiver-patient relationship, (3) uncertainty and perceived sense of unpreparedness for the surgery and caregiving duties exacerbated caregiver stress, and (4) caregivers universally desired more perioperative guidance and support. CONCLUSIONS: Informal caregivers took on many responsibilities, often felt overwhelmed and unprepared, and expressed a need for greater support and guidance. Early identification and targeted interventions to address caregiver needs may help optimize the well-being of caregivers and the older adults they support.