Abstract
Background
Family carers provide vital support for patients towards end of life, but caregiving has considerable impact on carers’ own health. The scale of this problem is unknown, as previous research has involved unrepresentative samples or failed to fully capture caregiving close to death.
Aim
To quantify level of psychological morbidity and general health among a census sample of carers of people with cancer at end-of-life , compared to population reference data.
Design
National four-month post-bereavement postal census survey of family carers of people who died from cancer, retrospectively measuring carers’ psychological health (GHQ-12) and general health (EQ-VAS) during the patient’s last three months of life.
Participants
N=1504 (28.5%) of all 5271 people who registered the death of a relative from cancer in England during two weeks in 2015 compared with data from the Health Survey for England 2014 (N=6477-6790).
Results
Psychological morbidity at clinically significant levels (GHQ-12≥4) was substantially higher among carers than the general population (83% versus 15%), with prevalence 5-7 times higher across all age groups. Overall carers’ general health scores were lower than population scores, median 75 (interquartile range 50-80) versus 80 (IQR 70-90), but differences were more marked at younger ages. Female carers had worse psychological morbidity and general health than male carers.
Conclusions
Levels of psychological morbidity among family carers during end-of-life caregiving are far higher than indicated by previous research, indicating a substantial public health problem. Consistent assessment and support for carers to prevent breakdown in caregiving may produce cost savings longer term.
Family carers provide vital support for patients towards end of life, but caregiving has considerable impact on carers’ own health. The scale of this problem is unknown, as previous research has involved unrepresentative samples or failed to fully capture caregiving close to death.
Aim
To quantify level of psychological morbidity and general health among a census sample of carers of people with cancer at end-of-life , compared to population reference data.
Design
National four-month post-bereavement postal census survey of family carers of people who died from cancer, retrospectively measuring carers’ psychological health (GHQ-12) and general health (EQ-VAS) during the patient’s last three months of life.
Participants
N=1504 (28.5%) of all 5271 people who registered the death of a relative from cancer in England during two weeks in 2015 compared with data from the Health Survey for England 2014 (N=6477-6790).
Results
Psychological morbidity at clinically significant levels (GHQ-12≥4) was substantially higher among carers than the general population (83% versus 15%), with prevalence 5-7 times higher across all age groups. Overall carers’ general health scores were lower than population scores, median 75 (interquartile range 50-80) versus 80 (IQR 70-90), but differences were more marked at younger ages. Female carers had worse psychological morbidity and general health than male carers.
Conclusions
Levels of psychological morbidity among family carers during end-of-life caregiving are far higher than indicated by previous research, indicating a substantial public health problem. Consistent assessment and support for carers to prevent breakdown in caregiving may produce cost savings longer term.
| Original language | English |
|---|---|
| Journal | Palliative Medicine |
| Early online date | 21 Aug 2018 |
| DOIs | |
| Publication status | Published - 2018 |
Keywords
- family caregivers
- mental health
- palliative
- end of life
- cancer
- survey
- health status
Research Beacons, Institutes and Platforms
- Manchester Institute for Collaborative Research on Ageing
