Grant R21CA124606

Support of the Caregiver of the Older Cancer Patient Undergoing Chemotherapy

Providing care for a cancer patient is a very difficult and stressfuljob. The family caregiver is considered to be a critical member of the healthcare team and pivotal to a patient's adherence to treatment. As age is a major risk factor for cancer, the majority of cancer patients are older adults, and their caregivers are either adult children or older adults residing with the patient. Older cancer patients can benefit greatly from cytotoxic chemotherapy but are at greater risk than younger adults of certain complications resulting in unpleasant and serious side effects, in particular, less toleration of the toxicity of the chemotherapy treatment, which is exhibited as physical symptoms that dramatically increase caregiver tasks. Symptom management is a major concern of older patients and their caregivers, and appraisal of patients symptoms may dramatically affect caregiver well-being. In the older adult caregiver, problems associated with aging may compound an already stressful situation. Researchon interventions for cancer caregivers of the older cancer patient is very limited. In general, psychosocialinterventions for cancer caregivers are thought to be helpful, with psychoeducational interventions being the most effective. One promising approach to caregiver intervention, particularly for short-term interventions, is problem-solving therapy. The present study is a 2- year longitudinal study using a 2-group experimental design. Applying a stress process model, we hypothesize that a brief psychoeducational intervention focused on symptommanagement and problem- solving, and delivered to caregivers of older cancer patients receiving chemotherapywill (a) improve the quality of life of the caregiver, (b) improvetreatment outcomefor the patient through better adherence to optimal treatment regimen, and (c) improvethe quality of life of the patient. As the population ages and cancer survival rates improve, more older caregivers will be faced with providing short-term symptom management during a very critical time in the older cancer patient's treatment. This study provides an opportunity to address problems associatedwith intense short-term caregiving in this expanding population.