Associations of financial hardship with suicidal ideation among bereaved cancer caregivers

Abstract

Purpose To examine associations between financial hardship and suicidal ideation among bereaved informal caregivers of cancer patients. Design Longitudinal cohort study Sample 173 informal caregivers of advanced cancer patients Methods Caregivers were interviewed a median 3.1 months before and 6.5 months after the death of the patient they cared for. Logistic regression models estimated associations between caregiver-perceived pre-loss and post-loss financial hardship due to the patient’s illness and post-loss suicidal ideation. Findings Suicidal ideation was identified in 12% (n = 21) of the sample pre-loss, rising to 20% (n = 34) post-loss (p=.049). Pre-loss financial hardship (OR = 3.4, 95% CI = 1.5–7.4, p=.002) and post-loss financial hardship (OR = 3.7, 95% CI = 1.7–8.2, p=.001) were each bivariately associated with post-loss suicidal ideation. In multivariable models adjusting for pre-loss suicidal ideation, psychiatric diagnosis, and spousal relationship to the patient, post-loss financial hardship remained significantly associated with post-loss suicidal ideation (AOR = 3.6, 95% CI = 1.4–8.8, p=.006). Conclusion Among a cohort of cancer caregivers followed from active caregiving into bereavement, post-loss financial hardship was associated with suicidal ideation in bereavement. Implications Economic policies that financially benefit caregivers may represent promising strategies for preventing suicidal thoughts and behaviors.