Beyond pain relief: a thematic exploration of informal caregiver experiences and needs following SPING block treatment in geriatric hip fracture patients

PurposeTo explore informal caregivers' experiences and preferences regarding decision-making and care processes following the Spinal Phenol IN Glycerol (SPING) block as non-operative pain management in frail older care recipients with a hip fracture. The aim is to improve the care process of the SPING block and improving communication with and support for informal caregivers.MethodsA single-center qualitative study was conducted at Amphia Hospital (the Netherlands) using semi-structured interviews. Informal caregivers of frail, older patients with hip fracture treated with SPING block were purposively sampled until saturation was reached. Interviews were audio-recorded and transcribed verbatim for thematically analysis.ResultsFour dominant themes were identified: (1) Pain relief as a core treatment priority; (2) Complex decision-making and the caregiver's moral burden; (3) Emotional toll and coping with witnessing decline; and (4) Shifting roles and long-term caregiving burden. SPING block was viewed as an acceptable, often preferred non-operative pain management. Informal caregivers valued rapid analgesia and the possibility of early discharge yet described insufficient communication and uncertainty around long-term effects. The caregiving burden extended beyond hospital discharge, with many reporting distress and role conflict.ConclusionInformal caregivers prioritize effective analgesia, compassionate communication and continuity of care when navigating decisions about SPING block in the context of frailty and end-of-life care. These findings underscore the importance of integrated, multidisciplinary protocols that facilitate timely decision-making, align with patient goals and address caregiver needs across care settings. Prospective studies are warranted to evaluate patient-centered outcomes of SPING block and its long-term analgesic effects.