Caregivers and legal barriers: navigating care of a family member diagnosed with cancer

Abstract

Caregivers of patients with cancer frequently coordinate care while navigating insurance, employment, financial, and benefits systems, yet their legal and administrative needs remain poorly characterized. We analyzed caregiver-initiated consultations in national non-profit organization’s Legal & Financial Navigation Program from 2021 to 2024. Among 1,091 consultations, caregivers were predominantly female (67.7%) and working age (19-64y, 60.8%); 10.9% lived in a different state than the patient. Caregivers reported 1,889 legal concerns, most commonly involving health insurance (32.1%), finances (24.0%), disability insurance (14.2%), and employment (11.8%). More than half (51.1%) reported multiple concurrent legal concerns. In adjusted analyses, residence in the South was associated with higher odds of multiple barriers than the Northeast (odds ratio [OR] = 1.60), whereas Marketplace, Medicaid, and Medicare coverage were associated with lower odds relative to employer-sponsored insurance. These findings support caregiver-focused screening, education, and legal navigation as components of supportive oncology care.