Family Care for the Older Person With Cancer

doi:10.1016/j.soncn.2005.10.006

Seminars in Oncology Nursing

Volume 22, Issue 1, February 2006, Pages 43-50

https://doi.org/10.1016/j.soncn.2005.10.006 Get rights and content

Objectives

To describe the needs of family members of older persons undergoing cancer treatment and to examine the interventions designed to alleviate caregiver distress.

Data Sources

Research studies and published articles.

Conclusion

Interventions to reduce distress for caregivers of older persons with cancer have the potential to lower patients’ hospital re-admissions and interruptions in cancer treatment and to improve patients’ and caregivers emotional health.

Implications for Nursing Practice

Oncology practitioners must consider the needs of family caregivers when planning and implementing interventions to improve or maintain caregiver health.

Section snippets

Consequences of Providing Care for an Older Person with Cancer

Caring for an older person with cancer can be a stressful experience, resulting in changes in the caregivers’ emotional and physical health that will often continue beyond the patient’s active cancer treatment.1, 3 Caregivers of older persons with cancer tend to be older themselves, either spouses of the patient or adult children with multiple competing demands, placing them at risk for negative emotional and physical consequences from providing care.

Functional Disability

The patient’s functional status is influenced by variables such as cancer stage and treatment regimen, and the patient’s health status before the cancer diagnosis. Functional disability mandates the intensity of care19, 20 and the degree of assistance required from the caregiver. Specifically, the site and stage of cancer, length of illness, comorbid conditions, cancer treatment protocols, and symptom experiences²¹ have all been found to affect the patient’s functional status and care required

Caregiver Age

As previously described, caregivers of older persons with cancer tend to be older as well, which may decrease their ability to provide care. Older caregivers often have co-morbid conditions, resulting in decreased physical capacity and vitality. Social isolation and decreased or fixed family resources can pose problems for older caregivers; they are more likely to become enmeshed in the care situation (often because they provide care without assistance from secondary caregivers) and isolate

Interventions for Caregivers of Older Persons With Cancer

Caregivers of persons with cancer require knowledge, skills, and guidance to provide care, and caregivers who feel prepared to deliver care have less burden.² Skills for caregivers of older persons with cancer include performing complex monitoring tasks, supervising and interpreting patients’ symptoms, assisting with decision-making, providing emotional support and comfort, and coordinating care.1, 2 In addition, caregivers must interact with the health care system to obtain information,

Conclusion

Although the interventions studies summarized here have shown promise in reducing caregiver distress, family and personal development change over time and it is important to note that not all interventions may be effective with caregivers of older persons with cancer. Oncology practitioners must consider the needs of family caregivers when planning and implementing interventions to improve or maintain caregiver health (see Table 1 for specific recommendations). Professionals must identify

Barbara Given, PhD, RN, FAAN: University Distinguished Professor, College of Nursing, Michigan State University, East Lansing, MI.

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Barbara Given, PhD, RN, FAAN: University Distinguished Professor, College of Nursing, Michigan State University, East Lansing, MI.

Paula R. Sherwood, PhD, RN, CNRN: Research Assistant Professor, University of Pittsburgh School of Nursing, Pittsburgh, PA.

View full text

Family Care for the Older Person With Cancer

Objectives

Data Sources

Conclusion

Implications for Nursing Practice

Section snippets

Consequences of Providing Care for an Older Person with Cancer

Functional Disability

Caregiver Age

Interventions for Caregivers of Older Persons With Cancer

Conclusion

Soc Sci Med

Soc Sci Med

Hematol Oncol Clin North Am

Prev Med

Lancet

J Pain Symptom Manage

Patient Educ Counsel

Soc Sci Med

Effect of caregiver perception of preparedness on burden in an oncology population

Oncol Nurs Forum

The influence of the cancer patient’s symptoms, functional states on patient’s depression and family caregiver’s reaction and depression

Health Psychol

Caregiving as a risk factor for mortalityThe caregiver health effects study

JAMA

Psychological Stress and the Coping Process

Forgotten voicesLessons from bereaved caregivers of persons with a brain tumor

Int J Palliat Nurs

Couples’ adjustment to breast disease during the first year following diagnosis

J Behav Med

Caregiver role strain

Caregiver depression following traumatic brain injuryA consequence of adverse effects on family members?

Brain Inj

Negative and positive health effects of caring for a disabled spouseLongitudinal findings from the Caregiver Health Effects Study

Psychol Aging

Caregivers’ descriptions of sleep changes and depressive symptoms

Oncol Nurs Forum

Chronic stress alters the immune response to influenza vaccine in older adults

Proc Natl Acad Sci U S A

Rewards, costs, and coping of African American caregivers

Nurs Res