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Grand Rounds
January 25, 2012

Caregiving Burden, Stress, and Health Effects Among Family Caregivers of Adult Cancer Patients

Author Affiliations

Author Affiliations: US Public Health Service, Clinical Nurse Scientist, Nursing Research & Translational Science, Nursing & Patient Care Services, Health Clinical Center (Dr Bevans); and Neuroendocrine Immunology and Behavior Section, National Institute of Mental Health (Dr Sternberg), National Institutes of Health, Bethesda, Maryland.

JAMA. 2012;307(4):398-403. doi:10.1001/jama.2012.29

Unlike professional caregivers such as physicians and nurses, informal caregivers, typically family members or friends, provide care to individuals with a variety of conditions including advanced age, dementia, and cancer. This experience is commonly perceived as a chronic stressor, and caregivers often experience negative psychological, behavioral, and physiological effects on their daily lives and health. In this report, we describe the experience of a 53-year-old woman who is the sole caregiver for her husband, who has acute myelogenous leukemia and was undergoing allogeneic hematopoietic stem cell transplantation. During his intense and unpredictable course, the caregiver's burden is complex and complicated by multiple competing priorities. Because caregivers are often faced with multiple concurrent stressful events and extended, unrelenting stress, they may experience negative health effects, mediated in part by immune and autonomic dysregulation. Physicians and their interdisciplinary teams are presented daily with individuals providing such care and have opportunity to intervene. This report describes a case that exemplifies caregiving burden and discusses the importance of identifying caregivers at risk of negative health outcomes and intervening to attenuate the stress associated with the caregiving experience.