Helping caregivers of older adults with cancer manage patient care: A qualitative analysis of healthcare professional perspectives

Abstract

Introduction

Family and/or unpaid caregivers play an important role in managing care for older adults with cancer (aged ≥65 years). Despite the development of theoretical models that emphasize the need for medical teams to assess caregiver abilities and integrate this assessment into patient care plans, little is known about what specific caregiver abilities should be prioritized for assessment and how such assessments should be conducted.

Materials and methods

In this interpretive description qualitative study, we conducted individual, semi-structured interviews with healthcare professionals (HCPs) who are involved in caring for older adults with cancer. All participants were recruited from a single large academic medical center between June and September 2024. The interviews focused on: (1) the caregiver abilities of interest to HCPs, (2) how HCPs assess these abilities, and (3) how HCPs respond to caregiver-reported deficits in these abilities. All interviews were audio-recorded and transcribed. Two analysts analyzed the transcripts using inductive thematic analysis and open coding.

Results

We interviewed 19 HCPs from diverse specialties (mean age: 45 ± 1.7 years, 90% female, 90% White). HCPs expressed interest in various caregiver abilities, including physical or functional capacity, cognitive function, medical knowledge and skills, emotional ability to cope with cancer diagnosis, financial ability (e.g., accessing medications), and availability. HCPs reported assessing caregiver abilities based on interactions with caregivers or using informal direct questions. They also reported several challenges in this assessment such as time limitations in clinical settings and ambiguity regarding their responsibility in evaluating caregiver abilities. When responding to deficits in caregivers' abilities, HCPs usually encourage caregivers to seek available social support or connect them with relevant resources. If caregivers need to develop specific caregiving skills, HCPs use more deliberate methods (e.g., a teach-back approach) to evaluate their abilities and provide direct support, including helping simplify caregiving tasks, providing necessary supplies or equipment, and offering various learning methods.

Discussion

We did not identify a systematic approach among HCPs to assessing these abilities. Given HCP-reported challenges in this assessment, our study highlights the need for a formal caregiver ability assessment to identify caregiver challenges and inform patient care plan development.