Depression Symptoms in Cancer Caregivers

Henry R. Rivera Jr., MS, ACNP-BC, AOCNP®

Disclosures

Clin J Oncol Nurs. 2009;13(2):195-202. 

In This Article

Abstract and Introduction

Abstract

Patients with cancer are living longer as the disease has become a more chronic condition. Family and friends assume the role of caregiver as more cancer care shifts to the home. The value of informal caregivers and the support they provide to patients will continue to increase. However, caregiving has physical and psychological consequences, including depression. The purpose of this article is to increase awareness of the problem of caregiver depression because of its impact on health deterioration and early death in caregivers. This article discusses caregiving, depression, factors that may contribute to caregiver depression, and implications for oncology nurses. A case study, examples of instruments that can be used to identify caregivers exhibiting depressive symptoms, caregiver resources, and mental health resources are provided.

Introduction

A 50-year-old woman with colon cancer and metastasis had been receiving chemotherapy after surgery. Her husband, her primary caregiver, reported increased fatigue and a general feeling of malaise to his primary care provider. After an extensive physical examination and complete diagnostic workup, the 52-year-old caregiver was found to be in good general health. He was advised to avoid stress and get more rest.

Several weeks later, the caregiver accompanied his wife to a visit to her nurse practitioner. When the nurse practitioner casually asked the caregiver how he was, he reported he had been having difficulty sleeping, increased fatigue, weight loss, and frequent colds. Upon further inquiry, the caregiver revealed he was worried about his wife's condition and their finances. His wife was often fatigued and not well enough to assist in most of her previous roles, including those at work and in the home. Their children were helpful, but one was away at college and the teenage child at home had many school and social activities. The caregiver reported he was often too busy with job and home responsibilities to attend meetings and social activities of the community organizations to which he belonged. He and his wife were less able to socialize with their friends since she began treatment. The caregiver revealed he often felt sad, overwhelmed, and unsure he was providing adequate care and support to his wife.

In a separate conversation with the oncology nurse practitioner, the caregiver's wife reported fatigue, trouble sleeping, sadness, loss of interest in activities she once enjoyed, and guilt over the burden her illness was to her family.

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