Case Study: When You Care for Someone with CancerFeb 27, 2012
Someone being treated for cancer often needs a lot of help at home, too. Usually a spouse, partner, adult child, or close friend becomes the primary caregiver who provides transportation, keeps house, prepares meals, provides emotional support, and communicates with other relatives and friends. The caregiver may also help feed, dress and bathe the patient, give drugs, manage side effects, report problems, and manage financial and insurance issues.
The physical and emotional toll of these tasks often leads to a lot of stress and a negative impact on the caregiver’s own health. In fact, the level of distress for the caregiver can sometimes be as high as it is for the patient. Caregivers have less time for their own needs, and often spend less time on leisure activities, have less contact with family and friends, don’t get as much sleep or exercise, and ignore their own physical health concerns.
There may also be a financial impact. Caregivers may work fewer hours, take a leave of absence, or move closer to the patient.
Researchers from the National Institutes of Health say health care providers should devote some attention to caregivers, in addition to the patients they’re caring for, to help relieve some of this burden. The researchers detailed the case of one caregiver in a recent article published in the Journal of the American Medical Association.
The caregiver was a 53-year-old woman whose husband had an aggressive bone marrow cancer called acute myeloid leukemia. He was hospitalized to undergo a stem cell transplant, a complicated procedure that can often have major side effects. His hospital stay and recovery was prolonged because of complications that included fluid around the heart, kidney failure, pneumonia, and graft vs. host disease. During the next several weeks, he was readmitted twice for additional complications including heart failure. He died during his last hospital stay.
During the time she cared for her husband, the wife, like many caregivers, complained little to the health care team, not wanting to take the focus away from the person being cared for. But when asked, she reported symptoms of stress that included anxiety, depression, loneliness, emotional distress, fatigue, lack of energy, trouble sleeping, and difficulty staying focused. Financial concerns added to her stress level. The transplant center was 143 miles away, so the couple had to move into temporary housing near the center. Both were unemployed due to disability, yet she was also supporting her father, mother and aunt.
The stresses associated with caregiving can increase the risk of illness in the caregiver. And like many caregivers, the wife in the case study already had a history of health problems and was dealing with additional stressful events. She had had heart bypass surgery and arthritis, and she was a smoker. Four months after her husband’s death, her father died. Shortly after that, she had a heart attack and needed a pacemaker.
The study’s authors suggest that health care providers assess caregivers for health problems when they accompany the patient to medical visits. Caregivers could be asked to complete questionnaires about their stress levels and lifestyle behaviors like smoking, alcohol use, eating habits, and exercise. Nurses, doctors, or social workers could interpret the responses and provide guidance in the form of pamphlets, referrals to specialists, or information about community resources. These actions could help caregivers cope better and be more prepared for the tasks they must do, the researchers say.
In her blog post, American Cancer Society Director of Survivor Programs Greta Greer, MSW, LCSW, recommends that caregivers ask for help from others, so they have time to take care of themselves as well as their patients. She writes, “In fact, studies indicate that taking care of yourself can actually help you be a better caregiver.”
The American Cancer Society’s online communities can help you connect with others who are going through a similar experience and find helpful information.
Caregiving Burden, Stress, and Health Effects Among Family Caregivers of Adult Cancer Patients. Published in the Jan. 25, 2012 issue of the Journal of the American Medical Association (Vol. 307, No. 4). First author: Margaret Bevans, RN, PhD, LCDR, National Institutes of Health, Bethesda, Md.