Table 1.

Summary of Protocol

	Week 1 Topic: Hospice	Week 2 Topic: Pain	Week 3 Topic: Shared Decision Making	Week 4 Topic: Dying Process
Monday
Objective	Caregivers will understand the philosophy of hospice.	Caregivers will be able to recognize and assess patient pain.	Caregivers will understand the concept of shared decision making and will learn how to engage in shared decision making with their hospice team.	Caregivers will better understand the dying experience and will learn strategies to communicate with patients who are dying.
Text for Post	We’ve made four short videos for this group. They are each about five minutes long. Our story focuses on Marinela, a woman caring for her husband, Tom, as he receives hospice services. In this week’s episode, Marinela struggles to come to terms with Tom’s diagnosis.	This week’s episode addresses pain.	In this week’s episode, Marinela makes an important decision to call hospice instead of 911 when Tom appears to be in pain.	This week’s episode takes us through Tom’s final journey: the dying process.
Link	Video links here
Discussion questions	> Did you learn anything new from this video? If so, what? > How is Marinela and Tom’s experience similar to or different from yours?	> What was the most important thing you learned from the video this week? > How do you know if your loved one is in pain?	> Do you feel like you are a part of the decision-making process with your hospice team? > If you feel comfortable, share information with the group about a time you had a similar experience to Marinela problem solving with your hospice team.	> Did this video help you better understand what to expect as your loved one is nearing death? > How might you lean on your support network during your loved one’s final days?
Tuesday
Objective	Caregivers will provide feedback on this week’s video.
Post text	In yesterday’s video, Marinela and Tom learned more about hospice from their nurse, Ricardo. Complete the poll below to answer the following question: On a scale of 1-5, with 1 being not at all and 5 being very much, how much did watching this video help your understanding of hospice care?	In yesterday’s video, Marinela learned more about pain from her husband’s hospice nurse. On a scale of 1-5, with 1 being not at all and 5 being very much, how much did watching this video help your understanding of assessing your loved one’s pain?	In yesterday’s video, Marinela worked with the hospice nurse, Ricardo, to decide how to treat her husband’s pain. On a scale of 1-5, with 1 being not at all and 5 being very much, how much did watching this video help you understand how to make decisions with your hospice team?	In yesterday’s video, Marinela cared for her husband, Tom, during his final days of life. On a scale of 1-5, with one being not at all and 5 being very much, how much did watching this video help you understand the dying process?
Link	Facebook poll: Please reply to the post by answering: 1 = Not at all 2 = A little bit 3 = Somewhat 4 = Quite a bit 5 = Very much
Discussion questions	Poll serves as discussion
Wednesday
Objective	Caregivers will provide personal updates and exchange support among group members.
Post text	How is everyone doing this week?
Link	No links today
Discussion questions	No specific discussion questions are provided for today.
Thursday- two posts
Objective	Caregivers will learn practical tips to enhance their wellbeing and will become and remain aware of group rules.
Post text	1. Caregiver Tip of the Day  2. Each month, I’ll be reposting our group rules so everyone can remain aware of them. While we haven’t had any problems in the past, we think it’s a good idea to share these with you periodically. Feel free to comment below if you have questions or concerns. You may also message me directly if you prefer to communicate privately. Thank you for making this group the safe and supportive environment it has become!
Link	1. Facilitator-selected Content  2. Attach the Group Rules of Conduct document, located under the Files tab in the Facebook group.
Discussion question	No specific discussion questions are provided for today.
Friday
Objective	Caregivers will understand what hospice is and how to utilize it.	Caregivers will understand what hospice care is and how to appropriately utilize it for both the patient and oneself.	Caregivers will identify opportunities to engage in shared decision making with their hospice team.	Caregivers will be able to identify signs of imminent death and will be able to identify ways to assist the patient during this stage.
Post text	Hospice care is a patient and family-centered approach that includes a team of doctors, nurses, home health aides, social workers, chaplains, counselors, and trained volunteers. Most of the time, family members or friends are patients’ primary caregivers. As you develop a relationship with your hospice team, each hospice staff member will want to know how to best support you and your loved one. It’s important that you let them know what your needs are. Learn more about the hospice team in the article below.	Have you heard of emotional or spiritual pain? It can be difficult to know if your loved one is in emotional or spiritual pain. Sometimes this appears to be physical pain, although it is not. The article below provides information on how to recognize emotional and spiritual pain	On Monday, we shared a video about shared decision making. In hospice, shared decision making requires family caregivers’ active participation. When making decisions with your hospice team, listen to team members’ suggestions for solutions and offer some of your own if you have them. Weigh the pros and cons of different options. Ask questions as needed. Think about how each possible solution relates to your personal values and preferences. Take time to make a final decision if you need it. Then work with your hospice team to decide what’s best. This article discusses the importance of talking about your values and preferences with your hospice team.	The article below is from the American Cancer Society. It discusses what to expect when a person with cancer is nearing death. While the article was written for caregivers, patients may also be interested in this information. In addition to listing signs that death may be close, the article also provides caregivers with some ideas about how to help during the dying process.
Link	Link to article about what patients and family need to know about hospice.	Link to article about pain management.	Link to article about communicating with healthcare provider.	Link to article about treatment at the end of life.
Discussion questions	> Did you learn anything new from this video? If so, what? > How is Marinela and Tom’s experience similar to or different from yours?	> If you or your loved one has experienced emotional or spiritual pain, how did this affect you as a caregiver? > What strategies have worked for you when trying to ease your loved one’s emotional or spiritual pain?	> What decisions have you made with your hospice team? > How do you let your hospice team know about your values and preferences regarding your loved one’s care?	> Are there special things you currently do or plan to do with your loved one or other family members when this time comes? > Was there anything in this article that surprised you, or was a new idea for you, about what caregivers can do to comfort a loved one in their final days?
Saturday
Objective	Caregivers will be aware that humor can be an effective coping strategy.
Post text	Silly Saturday
Link	Facilitator-selected Content
Discussion questions	No specific discussion questions are provided for today.
Sunday
Objective	Caregivers will feel uplifted and inspired.
Post text	Supportive Sunday
Link	Facilitator-selected Content
Discussion questions	No specific discussion questions are provided for today.