Caregiving daughters careprovision during cancer survivorship: Challenges and benefits

The trend in U.S. health care towards “de-hospitalization”, in combination with advances in cancer treatment, is making it possible for many elderly cancer patients to be managed on an outpatient basis and remain in the community while in treatment. Additionally, advances in cancer detection and treatment have increased the number of elderly cancer survivors. The need for care provision does not abate when active treatment has been completed. Cancer survivors may experience the residual symptoms of the disease itself, as well as the sequelae of the treatments received, consequently there is a growing number of elderly cancer survivors living in the community with illness and treatment-related needs. Adult children, primarily daughters, are a major source of support and assistance to older cancer patients. Elderly cancer survivors are likely to have extensive, complex and long-term needs. The persistence of symptoms into the survivorship period, as well as the emergence of new symptoms, can impede family members from relinquishing their care role once treatment ends. Daughters face complex challenges in their caregiving. They need to balance their parent=s caregiving needs with other responsibilities. This presentation will present data from a longitudinal study (n=312) of adult daughters (aged 22-62, 88% white, non-Hispanic, 6% Hispanic, 4% Black, non-Hispanic) providing care to an elderly parent (aged 60-90) who had been diagnosed with cancer. Interviews were conducted with the elderly patients and their caregiving daughters shortly after the parent's treatment initiation and continuing into the survivorship period, with follow-up interviews six and twelve months later. The analysis describes the impact of careprovision on daughters= daily life documenting the range of challenges adult daughter caregivers face and delineating the changes in careprovision that emerge during survivorship. The longitudinal data documents the range and intensity of burdens over the illness course, providing insight into the impact and consequences, both positive and negative, of the cancer caregiving experience on caregiving daughters. Given the increasing reliance on the family in long-term care, coupled with population aging, the incidence of dependency and the duration of careprovision will continue to expand. The burden of caregiving, already considerable on the family, will continue to grow. More attention needs to be focused on understanding the challenges families face over time. Such insights are critical in designing interventions and support services that can address the issues and resource needs that emerge and develop over time to help ensure carers' ability to remain involved in careprovision.