Caring for people at the end of life: How do cancer caregivers differ from other caregivers?

Abstract

9128 Background: The size of the population in receipt of cancer care is growing as the population ages and grows, with many receiving outpatient care, living for longer and wishing to be cared for at home. Hence, cancer is now one of the most common health conditions in receipt of informal care giving. Methods: The South Australian Health Omnibus is an annual, face-to-face, cross-sectional, whole-of-population, multi-stage, systematic area sampling survey which seeks a minimum of 3,000 respondents each year state-wide. From 2000-2007, questions about end of life were asked. This study compares people who cared for someone with cancer until death (cancer caregivers) with caregivers of people with other life limiting illnesses (non-cancer caregivers). Results: 4,665/14,624 (31.9%; participation rate 71.6%) had someone close to them die from an “expected” death in the 5 years prior to being surveyed. One in 10 (10%; 1,504/14,624) provided hands-on (day-to-day or intermittent) care; the majority (79.5%) having cared for someone with cancer. Compared to non-cancer caregivers, cancer caregivers cared for someone who was significantly younger (mean age 66 vs 74 years; p<0.0001), and to have had a palliative care service involved in the care of that person (64.9% vs 39%; p=0.000). Whilst not statistically significant, cancer caregivers were somewhat less likely to be the spouse of the person they cared for (11.8% vs 16.8%); more likely to be of non-English speaking background (11% vs 7.5%); more likely to report that the deceased was comfortable in the last 2 weeks of life (44.1% vs 31.7%); and prepared to care again for someone with a life-limiting illness (81.3% vs 71.4%). Conclusions: Caring for someone with cancer at the end of life appears to be fundamentally different to other caregiver populations, particularly in relation to age of, and relationship to, the patient, which may contribute to their substantially greater utilisation of palliative care services. Being a younger caregiver increases the likelihood of them caring again in the future.