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**82**

**85**

**Chapter 7**

**Abstract**

good death

distress.

**1. Introduction**

*Anshika Arora*

Caregiver Distress in Cancer

lence and factors associated with caregiver distress.

**Keywords:** caregiver distress, cancer, palliative care, psychological distress,

The incidence and prevalence of cancer has been increasing in developing countries in the last few decades. Cancer is viewed increasingly as a chronic disease, with prolonged management and increased rates of survival, leading to long term care requirements of the patient. In developing countries like India, the primary caregiver for long-term and intensive care of a cancer patient is preferably the family member, and sometimes family member is the 'only option' available to the patient as caregiver. The caregiver is usually a close relative like parent, child, sibling, spouse or a friend. This person usually has a deep relationship with the patient and more importantly, a significant emotional co-dependence. Cancer diagnosis and treatment not only affects patients but also their family, resulting in psychological

In cancer treatment, there has been a shift from in-patient care to ambulatory and out-patient care. This increases demands on the patient's caregiver towards unmet physical, psychosocial and spiritual needs of the patient. Most of the caregivers have little preparation or training to take up this role. With newer modalities of treatment, cancer patients have prolonged survival through all stages of disease, making it more of a chronic disease. These trends have definitely increased the caregiver burden. The act of caring for a sick patient is multifaceted. The caregiver needs to have dedicated time to take the patient for hospital appointments and care for disease and treatment related problems at home as well. The caregiver then may face loss of personal work due to lack of time. They may eventually develop varying

Cancer is a chronic disease with associated physical, emotional, social, financial and spiritual problems. The primary caregiver takes care of all these cancer-related issues for the patient. In India, usually a family member or loved one is the caregiver of the patient. The caregivers themselves feel distress and many factors may be associated with their psychological well-being. Pattern of distress may vary according to phases of the disease like at diagnosis, during ongoing oncological treatment, recovery period, remission period, recurrence of cancer, during end of life care and bereavement. Identifying and understanding caregiver distress is the first step. Active listening and good communication is important to unearth the real concerns and fears in order to relieve the distress. This chapter covers components of caregiver distress, assessment, physical, psychosocial and spiritual factors associated with distress and its management. Lastly, some recent literature related to preva-
