Title: THE FAMILY CAREGIVER OF THE OLDER CANCER PATIENT
Abstract: It is estimated that in 1999 about 1,221,800 new cases of invasive cancer will be diagnosed in the United States, and approximately 563,100 people are expected to die of cancer.32 More than 60% of all cases of cancer occur in persons aged over 65 years, and the cancer mortality rate in those aged over 55 years has increased by 17%.22 Families usually prefer to care for disabled relatives themselves, and older adults with chronic disease and disability usually want to remain in their homes, 15 where they can have a comfortable environment, maintain a normal life, and have access to family and friends. In recent years, shortened hospital stays and expanded outpatient care services for patients receiving adjuvant cancer treatment have further shifted the caregiving responsibility from health care professionals to the patients' families.30 Limited community services and the financial pressure associated with hospital and nursing home care also lead family members, particularly spouses and adult daughters, to assume caregiver roles. Family caregiving for older adults with cancer is the result of both demographic and health care delivery changes. Cancer causes changes in the family's identity, roles, and daily functioning, and the effect of such changes may be profound and long-lasting, regardless of the outcome of the disease.3 Despite the benefits of home care in cost-saving and convenience, family caregivers must deal with many unfamiliar situations and unexpected demands throughout the treatment and progress of the disease. Because caregiving may lead to hidden costs of care (negative effects experienced by the family members), attention to caregiving issues is important in understanding how this major, unpaid component of the health care and long-term care system works and what can be done to minimize the burdens of caregiving.15 Family involvement is also essential for the successful, comprehensive care of geriatric oncology patients; caregivers must work closely with doctors to monitor the patients' disease status, assist patients with self-care, and implement treatment regimens. With improvements in cancer diagnosis, treatment, and palliative care, cancer patients survive longer, and the length of the caregiving period has extended from days or weeks to months or years. The chronic yet progressive nature of this illness suggests that caregivers of cancer patients must face various challenges in different stages of the disease and with different levels of treatment. Greater psychosocial problems may arise when cancer metastasizes, 51 and the terminal phase, with the impending bereavement period, sees the peak impact.15 Although one study found a moderate feeling of preparedness in spouses of recently diagnosed elderly cancer patients, 50 family caregivers also expressed unmet needs for social, volunteer, and professional support as their own physical and emotional health suffered.61 More research is needed to document the specific issues involved in family caregiving for older patients with cancer.
Publication Year: 2000
Publication Date: 2000-02-01
Language: en
Type: review
Indexed In: ['crossref', 'pubmed']
Access and Citation
Cited By Count: 154
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