Caregiver Burden of Cancer Patients Related to Cognitive Decline at End of Life

Abstract

Background: Cognitive decline in cancer patients at the end of life makes it difficult for caregivers to manage symptoms and decide on cancer care. Objective: To define caregiver burden in relation to cancer patients with cognitive decline at the end of life. Methods: We use Walker and Avant’s eight-step concept analysis. We searched the MEDLINE, CINAHL, and Web of Science databases for relevant articles published between 2000 and 2020. Results: Caregiver burden for comorbid cancer and cognitive decline patients is defined as the pressure experienced by families in a multidimensional way due to the two deteriorating diseases in their process of facing the loss even before the deaths of patients and fulfilling their responsibilities as a family without knowing the patients’ own intentions. The antecedents included physical needs of caregiving, the cognitive decline of the patient, and whether the patient was dying. The consequences included caregivers’ physical and psychological health deterioration, decreasing caregivers’ coping abilities, and deterioration in the quality of death. Conclusions: This concept analysis indicated that the caregiver burden population should consider the characteristics of cancer and cognitive decline in interventions. Implications for Practice: Nurses should assess patients’ physical, psychosocial, and spiritual needs from various perspectives in advance to coordinate holistic care and prevent complications. Sharing the patient and caregiver’s history is important when discussing the patient’s wishes with the caregiver. Foundational: Caregivers in this population experience heavy responsibilities, multidimensional pressures, and the loss of patients before death. They are often required to be proxy decision-makers.