Family caregivers of elderly patients with cancer: understanding and minimizing the burden of care.

Family caregivers play an essential role, usually unpaid, in caring for patients with cancer. Most older patients with cancer are cared for by a family member, who may not be prepared for the challenges. The needs of older patients are diverse and may include assistance with medication, transportation for treatment, activities of daily living, and emotional support. The activities that caregivers find most stressful include helping patients with their self-care, managing their treatment and symptoms, and dealing with the suffering of a family member. Families may be affected by other stressors, such as changes in roles and employment and disruptions in schedules (eg, frequent clinic visits). Caregivers respond to these stressors differently; older spouses may be particularly vulnerable because of their own frailty. There can also be negative effects on caregivers' psychological, social, or physical health functioning. Social and economic deficits due to caregiving may include lifestyle disruption, less socializing, and greater out-of-pocket and lost productivity costs. Studies have shown, however, that caring for an older person with cancer also has rewards, such as satisfaction and a greater sense of self-worth. The negative aspects of caregiving can be lessened by psychological support and assistance in problem solving from healthcare professionals. Caregivers should also be provided with options to reduce the stress of frequent clinic visits, such as using long-acting growth factors or telephone triage. Educating caregivers on pertinent aspects of cancer management and the community resources available to them can be done through individual contact with health professionals or through more-formal educational programs.