Caregiver work modifications: A hidden cost of cancer care.

Abstract

190 Background: Recent national reports highlight the dramatically rising costs of cancer care and its impact on financial hardship among survivors. Comparatively little attention, however, has been paid to the contributions of family and friends in unpaid caregiving roles—specifically, the impact of caregiving on caregivers jobs and work life. Methods: Using data collected in the 2012 LIVESTRONG Survey of People Affected by Cancer, we examined the prevalence of cancer survivors reporting that they had a friend or family member providing care to them during or after cancer treatment. Then, among those reporting they had a caregiver employed at that time, we used logistic regression to examine caregiver work modifications (i.e., paid time, unpaid time off, changing hours or duties, or making a change in employment status. All models controlled for survivor age at diagnosis, sex, race/ethnicity, income, education and employment status as potential predictors. Results: Of the respondents (n = 6310), 88% reported a family member or friend provided care as follows (in non-mutually exclusive categories): spouses (64%), friends (47%), parents (40%), siblings (31%), children (28%) or other family member (14%). Among survivors with employed caregivers (n = 4,984), 41% reported that their caregiver made a work modification; of these 57% took paid time off, 41% took unpaid time off, 4% switched from full time to part time and 3% took early retirement. Caregivers were more likely to make work modifications for survivors with low (versus high) income or education and for unemployed (versus employed) survivors. The age of the survivor was also a significant factor, with caregivers making more work modifications for younger survivors (ages 18-64) compared to older survivors (age > 65)—with ORs of caregiver work modfications increasing from 1.70 to 6.92 in a dose response by survivor age. Conclusions: Family and friends provide care to a majority of individuals with cancer and many make substantial modifications to their work—contributions which are not routinely counted in estimates of the cost of cancer care. Interventions may be warranted to support caregivers, particular those of survivors with lower income, less education and those of younger age.