Credit: University of Missouri-Columbia

Currently, more than 34 million people in the U.S. care for terminally ill love ones, but few resources are available to help them navigate the challenges they encounter. A study at the University of Missouri School of Medicine found that nearly one-quarter of caregivers were moderately or severely depressed and nearly one-third had moderate or severe anxiety. The researchers recommend that health providers remember to treat the whole family, providing ongoing screening to family caregivers to identify early signs of depression and anxiety.

"While some sadness and worry are expected components of caring for a dying family member or loved one, clinical depression and anxiety shouldn't be," said Debra Parker-Oliver, Ph.D., professor in the Department of Family and Community Medicine at the MU School of Medicine and lead researcher of the study. "We have a population that is under immense stress and is not being acknowledged. Basic assessment tools should be used to help increase the likelihood of early detection and treatment of depression and anxiety in family caregivers."

Parker-Oliver and her colleagues conducted depression and anxiety assessments with 395 family caregivers. The researchers found that 23 percent of caregivers were moderately or severely depressed, and 33 percent of caregivers had moderate or severe anxiety. In addition, Parker-Oliver identified several risk factors associated with depression and anxiety among caregivers.

"We found that younger caregivers were more likely to be depressed or anxious," Parker-Oliver said. "We also found that caregivers who are married and caring for a family member with a diagnosis other than cancer, such as Alzheimer's disease, had higher levels of depression."

According to Parker-Oliver, many of these simple assessments are not used because of the misconceived notion among health providers that the family caregivers are not their patients.

"Health providers usually are more focused on the terminally ill patient instead of the entire family," Parker-Oliver said. "However, in many scenarios, it is a family disease. It's fair to say they have two patients: the caregiver and the person who is terminally ill."

Parker-Oliver said that assessment tools for depression and anxiety are widely affordable and have the potential for improved clinical outcomes for family caregivers in need of additional support.

The study, "The Prevalence and Risks for Depression and Anxiety in Hospice Caregivers," recently was published in Palliative Medicine. It was funded by the National Institute of Nursing Research and the National Cancer Institute.

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