A caregiver gives care to someone who needs help taking care of themselves. The person who needs help may be a child, an adult, or an older adult. They may need help because of an injury or disability. Or they may have a chronic illness such as Alzheimer's disease or cancer.

Some caregivers are informal caregivers. They are usually family members or friends. Other caregivers are paid professionals. Caregivers may give care at home or in a hospital or other health care setting. Sometimes they are caregiving from a distance. The types of tasks that caregivers do may include:

• Helping with daily tasks like bathing, eating, or taking medicine
• Doing housework and cooking
• Running errands such as shopping for food and clothes
• Driving the person to appointments
• Providing company and emotional support
• Arranging activities and medical care
• Making health and financial decisions

Caregiving can be rewarding. It may help to strengthen connections to a loved one. You may feel fulfillment from helping someone else. But caregiving may also be stressful and sometimes even overwhelming. You may be "on call" for 24 hours a day. You may also be working outside the home and taking care of children. So you need to make sure that you are not ignoring your own needs. You have to take care of your own physical and mental health as well. Because when you feel better, you can take better care of your loved one. It will also be easier to focus on the rewards of caregiving.

Caregivers are either formal or informal.

An informal caregiver is usually a relative or friend who may or may not live in the same house as the person they are caring for. A formal caregiver, such as a nurse, is paid and has training to care for a patient. Informal and formal caregivers help people with cancer during and after treatment in many ways.

Caregivers often provide care for cancer patients.

Being a caregiver means helping with the daily needs of another person. They may do the following:

• Help with personal needs, such as bathing, dressing, or shaving.
• Do household chores, such as cleaning, cooking, or laundry.
• Manage the person's finances.
• Plan for care and services.
• Visit often.

Caregiving can also be long-distance, such making appointments and planning care and services by phone or email.

Caregiver’s needs change over time.

The needs of caregivers change as the cancer patient goes from screening to diagnosis, to treatment, and to either long-term survivorship or the end of life. Worry and the need for information are two demands that most caregivers have during the patient’s cancer journey.

Caregivers may have questions about treatment and side effects, how to find helpful resources, and ways to practice self-care.

One of the demands caregivers have is the need for information. They may ask the health care provider about the following:

• The cancer: What can you tell me about the type of cancer he/she has?
• Risks and benefits: What are the risks and benefits of treatment?
• Side effects: How do I take care of his/her side effects while at home?
• Medical and nursing tasks: How do I give an injection? How do I set up the tube feedings?
• Recovery: How long will it take him/her to recover?
• Complementary and alternative therapies: Do I need to check with you before he/she uses a complementary and alternative (CAM) therapy? What CAM therapies are useful?
• Care for themselves: What are the best ways I can care for myself while caregiving?
• Emotions felt by patients and caregivers: What are some ways we can deal with what we are feeling?
• Local community-based resources: What are some local resources I can turn to?

Caregivers also have emotional, social, and financial demands.

Caregivers may need support for themselves, including help with the following:

• Managing their fears about the cancer patient’s condition and worry about the future.
• Keeping up with their job.
• Finding time for their friends.
• Paying their bills.

Caregivers may have some unmet needs when the patient becomes a cancer survivor.

When the cancer patient becomes a cancer survivor the needs of a caregiver decrease, but there may be concerns that continue. Some caregivers of cancer survivors worry about the following:

• If the cancer will come back.
• How to reduce stress in the survivor’s life.
• How to understand the survivor’s experience.

The end of life of a cancer patient increases caregiver distress.

Caregivers of patients who are nearing the end of life often have lower than expected mental and physical quality of life. Caregiver distress and the number of unmet needs increase as the patient’s end of life gets close.

Hospice care can provide much needed support to caregivers as well as cancer patients. Caregivers are often relieved by the higher quality of end-of-life care in hospice and the honoring of the patients’ goals.

Caregivers may find it hard to cope with the emotional and physical aspects of caring for someone with cancer.

It is easy to become overwhelmed as a caregiver. Caregivers may worry after hearing the cancer diagnosis or that cancer has come back. It can be hard to give support and stay positive if there is uncertainty about the patient’s future or the patient is suffering. Keeping up with the practical aspects of patient care, such as household chores and medical appointments, while also working, can be hard for the caregiver to balance. The patient also worries about these things, but the top concern of the patient and caregiver may not be the same, which may cause added stress.

Caregivers may feel burdened when caring for cancer patients.

Caregiver burden is the stress or strain felt by the person who cares for the family member or friend who needs help during a treatment or an illness. A burden is felt when the demands of caregiving are greater than the resources available to them. These demands can lead to negative effects of caregiving such as:

• Anxiety.
• Depression.
• Post-traumatic stress disorder.
• Decline in quality of life.

Caregiver burden may be increased by certain factors, such as gender and age.

The following factors may increase caregiver burden:

• Female gender. Women are more likely to have caregiver burden.
• Age. Caregiver burden can occur at any age but increases for the younger and older caregivers.
  • Older caregivers. Older caregivers are at risk for caregiver burden when they have the following conditions:
    • Health problems of their own that they neglect.
    • Fixed incomes.
    • Small social support networks.
    • Less time to exercise.
    • Trouble remembering to take their own medicines.
    • Fatigue from lack of sleep.
    • It is common that caregiving by older people may lead to depression, poor health, and even death.
  • Middle-aged caregivers. Middle-aged caregivers may often have to miss all or part of their workday. Some may even need to take a leave of absence.
  • Younger caregivers. Younger caregivers often juggle work and their own family duties. They may also have to give up part of their social lives.
• Race and ethnicity. People of different races and cultures approach caregiving in their own way.

  • Asian American caregivers. Asian American caregivers often provide more caregiving hours than White, African American, and Hispanic caregivers. They also use less support services, tend to have fewer financial resources, lower levels of education, and higher levels of depression than other groups of caregivers.

    Asian American individuals may not talk about death or dying because they believe it is bad luck. This can make it hard for healthcare providers to discuss prognosis and hospice care with them. Keeping a cancer diagnosis secret from the patient and not talking about it can add to a caregiver’s sense of burden and duty.

  • Hispanic and African American caregivers. Hispanic and African American caregivers often have strong family ties, which may prevent them from seeking help outside of their family. As a result, they may not use local health resources, including counseling and support groups, home care, long-term care, and hospice services. They usually have higher levels of caregiver strain, a lower household income, and are more likely to reduce their work hours compared with White caregivers.
• Socioeconomic status. Socioeconomic status is the social standing of someone that is measured by a person’s education, income, and job. People with a lower socioeconomic status may have less access to resources and financial help. Lower incomes and limited financial options may cause patients to make treatment-related choices that are not the same as their doctor prescribed.
• Employment. Caregivers may need to make changes in the hours they work at their job, make changes in their duties, or take paid or unpaid time off. Work progress may suffer when a caregiver is not focused and can lead to anxiety and depression. Women who have a job are more likely to feel burdened.
• Role strain. Other roles a caregiver may have include spouse, parent, child, friend, employee, or student. Role strain happens when the rights, duties, and behaviors of one role conflict with a different role. When caregivers perform more than one role, they may become stressed. However, many roles do not always lead to stress. For example, when a caregiver goes to work, they may benefit from the support of their employer and coworkers, and from the time away from caregiving.
• Site of care. Caregivers may have more burden when the cancer patient leaves the hospital and comes home. The caregiver now must help manage the patient’s symptoms and may be unsure about the prognosis or if the cancer can spread. Visits by home health nurses can help reduce this burden. Sudden changes in site of care, such as going back to the hospital, also increase caregiver burden.

There are many ways to help decrease caregiver burden.

The following therapies or skills may prevent or reduce caregiver burden:

• Cognitive behavioral therapy. A type of therapy that helps change the way a caregiver thinks and feels about certain things.
• Complementary and/or alternative therapies. Many options, such as guided imagery, massage therapy, or healing touch, are available to help caregivers manage stress and anxiety.
• Family/couples therapy. Counseling that helps families work through problems in a way that makes the family stronger.
• Interpersonal therapy. One-on-one counseling that focuses on your relationships with other people to reduce caregiver burden.
• Problem solving/skill building. Helping the caregiver develop skills that include the following:
  • Ability to assess and manage the patient’s symptoms.
  • Identify solutions to caregiving problems.
  • Enhance the caregiver’s ability to cope with cancer caregiving roles and duties.
• Psychoeducational. Providing caregivers with information about the following to help them better cope with their new role:
  • Diagnosis.
  • Prognosis.
  • Coping.
  • Self-care/home care.
  • Impact on partners and family.
  • Hospital care.
  • Follow-up and recovery.
• Palliative care. Using palliative care to improve the patient’s quality of life. When the patient’s quality of life is improved, the caregiver often feels less burdened.
• Supportive therapy. A type of therapy that addresses the emotional needs of caregivers.

While the caregiver can try most of these therapies or skills at any time during the cancer patient’s journey, it is most helpful to have them when the cancer patient is given palliative care or at the end of life to help reduce the burden of the caregiver.

Caregivers may find benefits from caregiving.

Being caregiver to a person with cancer can lead to personal growth. Reducing caregiver burden increases the positive effects of caregiving that often lead to personal growth in the following areas:

• Acceptance. Adjusting to things that cannot change.
• Family. Feeling a closer bond with family.
• Appreciation. Being aware of love and support and having a greater joy of life.
• Reprioritization. Arranging life priorities in a new order of importance.
• Increased faith. Having a greater sense of closeness to God and renewed spiritual practices.
• Empathy. Understanding and feeling what others feel.
• Positive self-view. Feeling good about self.
• Better health habits. Eating a healthy diet, getting more exercise, and keeping up with medical check-ups.

People who have cancer often live at home and get help from loved ones such as their spouse, family members, friends, or neighbors. If you are caring for a cancer survivor, we offer some helpful tips below.

Going to the Doctor

If you take your loved one to the doctor, you can do some very important tasks—

• Before the visit, write down questions and information you or your loved one want to share with the doctor, like new symptoms or possible side effects.
• Bring a list of medicines that your loved one is taking.
• Write down what the doctor says.
• Make sure you both understand what to do next.

Preventing Infections

Cancer patients treated with chemotherapy are more likely to get an infection. That’s because chemotherapy can weaken the immune system.

To help make sure your loved one with cancer doesn’t get an infection—

• Stay clean and wash your hands often.
• Get a flu shot every year, and encourage the patient to get one, too.
• Get the COVID-19 vaccine and any booster doses to stay up-to-date.
• Practice good health habits to help stop germs from spreading.
• If you notice any cuts or scrapes on the patient’s skin, help clean and bandage them.

Call a doctor right away if you notice that the patient has any signs of an infection, especially a fever.

Reporting Possible Side Effects

Cancer treatments can cause many side effects. A side effect is a problem that occurs when treatment affects healthy tissues or organs. It’s important for you to watch for possible side effects.

Encourage your loved one with cancer to talk to the doctor about any physical, mental, or emotional changes. The doctor may be able to help your loved one manage these changes.

Making Choices to Stay Healthy

You can also encourage your loved one to make healthy choices that will lower the chance of getting cancer again, like—

• Staying away from tobacco. If your loved one smokes, help him or her try to quit, and to stay away from other people’s smoke.
• Limiting the amount of alcohol he or she drinks.
• Protecting his or her skin from overexposure to ultraviolet rays from the sun and tanning beds.
• Eating lots of fruits and vegetables.
• Keeping a healthy weight.
• Being physically active.

Someone who feels supported is more likely to quit smoking for good. That’s why friends, family members, and significant others can play a big part in helping a person become smokefree.

Getting Follow-Up Care After Treatment Ends

You can help your loved one get follow-up care—checkups and tests to find early signs of new or the same cancer. After each visit to the doctor, make sure you understand what your loved one needs to do next.

People with cancer may feel stressed and overwhelmed. It’s normal for them to feel anxious, afraid, angry, or depressed. Cancer treatments also can cause them to have trouble concentrating or remembering things. These feelings and problems can make it hard for them to work or do normal daily activities.

If you’re caring for someone with cancer, you have an important role in helping him or her cope mentally and emotionally.

What Can I Do?

• Be sensitive to your loved one’s feelings, and encourage him or her to talk about them with you and other family members and friends.
• If your loved one is worried about money, see our list of resources that may be able to help.
• Encourage your loved one to join a support group.
• Ask your loved one’s doctor for a referral to mental health and social support services.
• Help your loved one stay as active as possible. Physical activity has been linked to lower risk of depression, as well as lower rates of recurrence of certain kinds of cancer, among survivors.

You do many things to help take care of your loved one with cancer. Stress from these demands can cause health problems, including sleep problems and appetite changes. You may feel anxious, depressed, or even lonely. About half of caregivers don’t get enough restful, continuous sleep, making them feel tired and leading to a poor quality of life.

It’s important for you to take care of yourself physically, mentally, and emotionally.

Ways to Stay Physically Healthy

• Don’t use tobacco. If you smoke, try to quit. Stay away from other people’s smoke.
• Limit the amount of alcohol you drink.
• Eat lots of fruits and vegetables.
• Keep a healthy weight.
• Be physically active.
• Get enough restful sleep.
• Get health checkups regularly.
• Get a flu shot every year.
• Get the COVID-19 vaccine and any booster doses to stay up-to-date.

Ways to Stay Mentally and Emotionally Healthy

• Feeling overwhelmed? Try to arrange for respite care. Respite care is temporary care given to a person who is unable to care for himself or herself, so the person’s usual caregivers can have a break. If you’re having trouble finding someone to help, ask your loved one’s health care team about community resources.
• Reach out to family members, friends, those who share your faith, or a support group for emotional support.
• Worried about money? Many caregivers provide financial support, reduce their work hours, or even quit their job to care for their loved one. See our list of resources that may be able to help.
• Stay active. Regular physical activity can lower your risk for depression.