Stress of Family Caregivers Attending Cancer Patients

By Dr Suresh Rao
Dr Suresh Rao is the chief of Radiation Oncology department at Mangalore Institute of Oncology (MIO) and is an expert in external-beam radiation therapy and brachytherapy.
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July 23, 2019

In the treatment and care of an individual afflicted with cancer, the role of family members is very important. In most cases, the family caregivers are spouse, parents, siblings and children and they form the backbone to the patient. During this time, the role of a family caregiver is extremely important and vital. Among the family members, one individual takes the major responsibility and is known as the primary or principal caregiver. Caregiving is a chronic stressor, and the providers often experience negative psychological, behavioral, and physiological effects on their daily lives and health.

In cancer, unlike with acute ailments like malaria or dengue, or non fatal chronic ailments like arthritis, the treatment is for a considerable period of time and depending on the stage may range from a minimum of 3 months to almost a year. Initially, when an individual is diagnosed with cancer, it causes sadness, anxiety, anger, or even hopelessness in the family members. In worse cases, the patients and other family members can also suffer from clinical levels of depression and severe levels of anxiety and stress reactions. However when the need for initiating treatment gets recognized, the family members set aside the personal grief and prioritize initiating the treatment.

Care giving for a family member with cancer is labor intensive. This is because the level of care required by the care recipient is greater than the burden experienced by those caring for other chronic ailments like arthritis and diabetes. The principal caregiver in specific will have to multitask during the care giving responsibilities, arranging finances, preparing/arranging meals, coordinating medication and other treatment-related activities and this is very true in the case of caring for cancer patients. The condition for the principal caregiver is worse if they are suffering from age related ailments like arthritis, diabetes and worse when arranging finances are an issue.

To substantiate this studies have shown that when compared to non-caregivers, caregivers often experience psychological, behavioral, and physiological effects that will subsequently affect the general health. This is principally because during treatment and care the focus of the family is on the afflicted member and seldom on the caregiver/s. The principal caregivers to cancer patients undergo severe emotional distress, fatigue and sleep impairment, which cumulatively will affect their general health. In most cases the caregivers providing higher levels of support are more likely to postpone their own health care needs and this can contribute to negative outcomes like impaired immune system function and coronary heart disease, and early death.

Family caregivers stress is an extremely important but sadly neglected aspect of cancer care in India. Family caregivers play an important role in the management of cancer and enlisting their cooperation and including them as the unit of care from the outset are important for effective management of cancer. At MIO, attempts are made at including family in treatment planning, decision making and implementation and that supportive strategy like psychological counseling and healthy de-stressing methods are suggested for the caregivers. This is very important as a stress free caregiver will always contribute better towards care of a person afflicted with cancer and the rest of the family.

Comment on this article

  • Naveen Dsouza, Surathkal

    Wed, Aug 7 2019

    You are an excellent doctor i have met... I thank you for treating my mom... U always cheerup patients and make them mentally strong to fight against doctor... I suggest he s the best doctor to tackle with cancer

    Agree

  • Vincent Rodrigues, Katapadi/Bangaluru

    Sat, Jul 27 2019

    Quite motivating and guiding article indeed and we hope to see many more motivating articles from you in the future as well.

    Agree [2]

  • Dan M, Dubai / Mangalore

    Fri, Jul 26 2019

    Disease management
    In a Spiritual angle

    Best way to tackle is to say or think that you love the cancer or for that matter any other disease (Much better Instead of slowly dying of the thoughts from the fear of the disease(s)). You love it means you surrender it to God as scriptures say God is Love. Over the time one can overcome the disease or get healed quickly, of course with the help of medicine and this positive thought.

    Generally 6 to 12 months of totally veg diet, less sugar intake, alkaline food one would definitely win over any type of Cancer of course with the help of medicine.

    More proteins - Uric acid
    More sugars - Diabetes
    More fatty foods - Cholesterol
    More salt intake - Blood pressure. So self-control in all of these makes you more healthier.

    Caretakers just need to imbibe positive thaughts for themselves as well as for the patients for the speedy recovery.

    Agree [3]

  • Anita Britto, Mangalore/Auckland

    Fri, Jul 26 2019

    Very useful article which addresses the emotional aspect which a Caregiver is confronted with.

    Your write-up brought to mind something I read which uses the analogy of the in-flight safety spiel before take-off when the Air personnel announces the need to put on your oxygen mask before attending to others. Failing to take care of yourself will only prolong suffering as it has the potential of a Caregiver succumbing to illness and thereby being unable to care for a loved one.

    Your suggestions combine an element of empathy, empowerment and hope and is very encouraging to a Caregiver who could easily feel overwhelmed with the enormity of the situation. There is a lot of complex information to process and it is essential to tap into available resources and surround yourself with well-wishers and a support network to bolster your optimism, prevent burnout and maintain a sense of humour despite the situation.


    To reiterate what you said I would encourage every caregiver to invest in themselves and find the time to recharge and reenergize and empower themselves with recent research in the field of Cancer.

    This is an area very close to my heart and it’s a great reminder for a caregiver never to work in isolation.

    Thank you for this well-informed article.

    Agree [3]

  • Eulalia Dsouza, Mangalore

    Thu, Jul 25 2019

    Dear Dr. Rao, so precisely right. Patients go through trauma that none can imagine, but people surely are with patients in general. But the care giver attending to Cancer Patients are never thought about. Indeed they go through a trauma of multitasking looking in to every minute need of the patients. So they need more cares and concern as well. Stress anxiety, emotions filled with a sense of uncertainty of a life in questions will all play in the mind of these care takers & this could drive a person crazy and dizzy.
    Stay Blessed always for all the good work you do to our society. Good Luck Dr. Rao.

    Agree

  • A Saldanha, Dubai

    Thu, Jul 25 2019

    Another great article by Dr Rao. Thanks, Doctor, keep writing articles on these much neglected area of healthcare.

    Agree

  • Shailesh, Mangalore

    Wed, Jul 24 2019

    Dear Dr. Rao,

    Hats off to you for this article ! Indeed you have hit the nail perfectly on it's head. I congratulate you Sir for your deep knowledge and understanding of the psychology or rather the hidden grief of the Caregiver ! It is truly a neglected subject which many a psychologists and counsellors can learn from it.

    Thank you Doctor !

    Agree [4]

  • Ivan Saldanha-Shet, Mangalore. Rosario

    Wed, Jul 24 2019

    My Dear Dr.,
    Indeed your article demands high appreciation and your concern is deep - Thank you.
    This observation is also valid in dwellings and homes for aged here. With life expectancy
    higher and nuclear families proliferating; children who have to work are not able to care for the
    aged and sick. At home and in institutions it is now the norm to have a care giver at high costs.
    These are mostly young and untrained who want to earn something by hook or crook., and come
    from far places. They serve in a way, but investigations prove many deficiencies. Thier young life
    is wasted away and they also become psychopaths sort of, if I may say.....The middle 'men' make a
    good killing, in this arrangement, there is no control. There is no regulation/monitoring by Govt. The time is well past for the Govt to form a suitable administrative body to organise and oversea this care which is vital and demands moral accountability too. Thank You.

    Agree [6]


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