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Perspective of the VAD Caregiver: The Transition Home

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Pamela Combs, PhD, RN
Advocate Christ Medical Center
Chicago, IL, USA

"The two most powerful warriors are patience and time." - Leo Tolstoy (1828-1910).

The most dramatic impact of being a caregiver is reflected in one of the waves of the Caregiver Health Effects Study (CHES), which discovered that caregivers are at greater risk of death than those who do not administer care to a significant other (Bookwala, Zdaniuk, Burton, Lind, Jackson, & Schulz, 2004). We often fail in evaluating the perspective of the caregiver of a patient with a VAD regarding preparation to care at home. Exactly what the VAD caregivers perceive of the transitioning experience from hospital-to-home is an area that is neglected of research studies. Therefore, as a nurse researcher, I desired to understand the meaning of the lived experience for caregivers of VAD patients during their transition from hospital to home.

Using Colaizzi's (1978) method, I had the privilege of interviewing 7 caregivers regarding their experience transitioning a newly implanted VAD patient home. The predominant theme of "power" dominated their experience, by blanketing the influence of: 1) electricity, 2) life, 3) control, 4) change, 5) a spiritual entity and 6) the unknown. Transitioning home from the hospital was associated with a variety of intense emotions. Although the interviews only provided snapshots of the issues and challenges faced by caregivers, these events and feelings were presented as crucial in their telling. VAD teams should consider assisting the caregiver in identifying stress management techniques to prevent a sense of feeling overwhelmed. VAD support groups that enable communication and provide information is recommended for caregivers as well as follow up phone calls with the VAD coordinator. These programs should focus on empowering caregivers and incorporating them as a part of the team as we do the patient. ■

Disclosure Statement: The author has no conflicts of interest to disclose.


  1. Bookwala, J., Zdaniuk, B., Burton, L., Lind, B., Jackson, S., & Schulz, R. (2004). Journal of Aging Health, 16(1), 88-115.
  2. Colaizzi, P. (1978). Psychological research as the phenomenologist views it. In R.S. Valle & M. King (Eds.), Existential-phenomenological alternatives for psychology research (pp. 48-71). New York: Oxford University Press.

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