In this issue of CMAJ, Grunfeld and colleagues present the results of their prospective study of 89 caregivers of women with advanced breast cancer for 3 years or until the patient's death. They found that, as patients moved into the last stages of their illness, greater proportion of caregivers became depressed (30%) and experienced a higher level of burden (26.2%) than the patients (9% and 19% respectively).
A significant proportion of caregivers had to miss work to look after their family member. The mean financial burden borne by families during the patients' illnesses was $8292 for those without and $5765 for those with extended health insurance.
The authors state that, with fewer cute care and palliative care beds in the hospital system, family caregivers will be increasingly relied on to provide support for dying cancer patients. In a related commentary, Zarit emphasizes that family caregivers are an essential part of the management team whose needs must be addressed during the course of the patient's illness.
p. 1795 Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers
– E. Grunfeld et al
p. 1811 Family care and burden at the end of life
– S.H. Zarit
Canadian Medical Association Journal