Technology-enhanced Transitional Palliative Care for Family Caregivers

There will be two groups in this randomized control study: technology-enhanced group and
usual care group. The total amount of subjects includes both the palliative care recipients
and the family caregivers (both the patients and their family caregiver will sign informed
consent.)

A family caregiver is broadly defined as the person self-identified as the family member or
unpaid friend who is the primary informal caregiver for a patient with a terminal illness.
The family caregiver may or may not be a member of the patient's nuclear family.

For the technology-enhanced group, the study nurse experienced in palliative care will have a
visit with the caregiver within the first 24 hours after consent, and have daily visits with
the caregiver as long as the patient is still in the hospital. During these visits, the nurse
will talk to the caregiver about their own self-care needs, begin transitional care planning,
and develop Readiness Plans to anticipate care giving needs the caregiver may have when they
return home.

For the technology-enhanced group, the caregiver will take an iPad home so that the study
team nurse can video chat with them. The iPad will need to be returned upon completion of the
study. The study nurse will have a video chat with the caregiver at home within 24-48 hours
of discharge from the hospital, and at least weekly for 8 weeks after that. The caregiver and
the study nurse may also decide to have other calls on the phone during this time.

For the usual care group, doctors and nurses along with input from the Palliative Care
service will help the caregiver make a plan for discharge from the hospital and for taking
care of the patient upon return home. Someone from the study team will call the caregiver
once a week to check in for the first 8 weeks after the caregiver and patient return home
from the hospital.

Both groups will be asked to complete questionnaires before starting the study, and then up
to seven more times over the course of 6 months.

Inclusion Criteria:

- Adult family caregiver of adult patient hospitalized at Mayo Clinic

- Receives in-hospital palliative care consult

- Family caregiver lives in a Minnesota or Iowa county that is designated as medically
under served or rural area

Exclusion Criteria:

- Patient's hospital discharge disposition includes long-term placement (>2 weeks) in a
skilled nursing or hospice facility

- Family caregivers who live in Rochester, Minnesota. (Rochester, Minnesota is not
considered a medically under served or rural area.)

- Patients with left ventricular assistive devices, documented chronic pain, use of home
infusion pain pumps, or documented addictive behaviors.