Impacts of Caregiving on the Caregiver's Quality of Life
Spiritual well-being may provide a stress-buffering effect for caregivers. Higher levels of spirituality are associated with lower psychological distress and improved well-being for caregivers. In addition, maintaining faith and finding meaning have been shown to mitigate the adverse effects of caregiving stress on mental health. Spirituality can fortify caregivers against hopelessness, help caregivers derive meaning from the cancer experience, and provide an existential perspective on hope and suffering. Any member of the oncology team can explore the spiritual or religious values that inform a person's response to caregiving, but generally speaking, the social worker and chaplain are most adept in this area. (Refer to the PDQ summary on Spirituality in Cancer Care for more information about spirituality and religion in cancer care.)
Positive Aspects of Caregiving
Caregivers assume their tasks for reasons that include a sense of familial obligation and loyalty and altruism in the face of their loved one's suffering; more practical reasons include lack of paid help and lack of insurance coverage for services. Other positive rewards of caregiving include the following:
- Discovery of personal strength through adversity.
- Improved sense of self-worth.
- Deepening of the relationship with the cancer patient.
- A sense of personal growth.
Studies have shown that caring for a patient with cancer has rewards such as satisfaction, closeness with the cancer patient, and a sense of fulfilling an obligation. Positive and negative aspects of caregiving are associated with psychological well-being and the caregiver's willingness to continue providing care.
The positive aspects of caregiving can be strengthened by psychological support and practical assistance with problem solving from health care professionals. Direct professional validation of caregivers and indirect support through the patient's medical care are associated with higher caregiver satisfaction and the willingness to continue providing care.[18,19]
To reduce the stress of frequent clinic visits, caregivers should also be provided with options such as using long-acting medication regimens or telephone triage. Educating caregivers about pertinent aspects of cancer management and available community resources can be accomplished through individual contact with health care professionals or through more formal educational programs.
- Kim Y, Given BA: Quality of life of family caregivers of cancer survivors: across the trajectory of the illness. Cancer 112 (11 Suppl): 2556-68, 2008.
- Kim Y, Duberstein PR, Sörensen S, et al.: Levels of depressive symptoms in spouses of people with lung cancer: effects of personality, social support, and caregiving burden. Psychosomatics 46 (2): 123-30, 2005 Mar-Apr.
- Carter PA: Caregivers' descriptions of sleep changes and depressive symptoms. Oncol Nurs Forum 29 (9): 1277-83, 2002.
- Travis LA, Lyness JM, Shields CG, et al.: Social support, depression, and functional disability in older adult primary-care patients. Am J Geriatr Psychiatry 12 (3): 265-71, 2004 May-Jun.
- Yabroff KR, Davis WW, Lamont EB, et al.: Patient time costs associated with cancer care. J Natl Cancer Inst 99 (1): 14-23, 2007.
- Glajchen M: Role of family caregivers in cancer pain management. In: Bruera ED, Portenoy RK, eds.: Cancer Pain: Assessment and Management. 2nd ed. New York, NY: Cambridge University Press, 2009, pp 597-607.
- Weitzner MA, McMillan SC, Jacobsen PB: Family caregiver quality of life: differences between curative and palliative cancer treatment settings. J Pain Symptom Manage 17 (6): 418-28, 1999.
- Hodges LJ, Humphris GM, Macfarlane G: A meta-analytic investigation of the relationship between the psychological distress of cancer patients and their carers. Soc Sci Med 60 (1): 1-12, 2005.
- Ferrell BR, Dow KH, Grant M: Measurement of the quality of life in cancer survivors. Qual Life Res 4 (6): 523-31, 1995.
- McMillan SC, Small BJ, Weitzner M, et al.: Impact of coping skills intervention with family caregivers of hospice patients with cancer: a randomized clinical trial. Cancer 106 (1): 214-22, 2006.
- Schulz R, Beach SR: Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA 282 (23): 2215-9, 1999.
- Taylor EJ: Nurses caring for the spirit: patients with cancer and family caregiver expectations. Oncol Nurs Forum 30 (4): 585-90, 2003 Jul-Aug.
- Kim Y, Wellisch DK, Spillers RL, et al.: Psychological distress of female cancer caregivers: effects of type of cancer and caregivers' spirituality. Support Care Cancer 15 (12): 1367-74, 2007.
- Colgrove LA, Kim Y, Thompson N: The effect of spirituality and gender on the quality of life of spousal caregivers of cancer survivors. Ann Behav Med 33 (1): 90-8, 2007.
- Ward SE, Berry PE, Misiewicz H: Concerns about analgesics among patients and family caregivers in a hospice setting. Res Nurs Health 19 (3): 205-11, 1996.
- Feinberg LF, Wolkwitz K, Goldstein C: Ahead of the Curve: Emerging Trends and Practices in Family Caregiver Support. Washington, DC: AARP Public Policy Institute, 2006. Issue Paper No. 2006-09. Also available online. Last accessed March 25, 2013.
- Balducci C, Mnich E, McKee KJ, et al.: Negative impact and positive value in caregiving: validation of the COPE index in a six-country sample of carers. Gerontologist 48 (3): 276-86, 2008.
- Haley WE: Family caregivers of elderly patients with cancer: understanding and minimizing the burden of care. J Support Oncol 1 (4 Suppl 2): 25-9, 2003 Nov-Dec.
- Kim Y, Schulz R, Carver CS: Benefit-finding in the cancer caregiving experience. Psychosom Med 69 (3): 283-91, 2007.