Review article: Financial stress and strain associated with terminal cancer—a review of the evidence

Abstract

Financial circumstances are a significant influence on the quality of life for older people and may be important to health and wellbeing at the end of life. The aim of this study is to review the evidence for the existence and consequences of financial stress and strain at the end of life for people dying with cancer. We conducted a systematic search of four electronic databases for studies, providing data on illness-related financial burden (stress), or perception of financial hardship (strain), from patients with terminal cancer or their caregivers. Twenty-four papers were identified from 21 studies published in English between 1980 and 2006, the majority (14) of cross-sectional design. Financial stress was reported in all 13 studies from the USA (median 33%, range 10-66%), but only four sought measures of financial strain. In the USA, specific social consequences, such as moving house or change in employment to cope with caregiving, were reported in four of these studies; one of these also noted changes in treatment choices and avoidance of care for other family members. In studies from outside the USA, there is a dearth of data on financial stresses and the consequences of this for the household, despite widespread reporting of financial strain. To fill a gap in our understanding and improve holistic palliative care, researchers need to ask the questions about the consequences of financial stresses and strain for the health and wellbeing of the household.

Review of the literature on the effects of caring for a patient with cancer

“…Although a few earlier reviews exist [12][13][14][15][16][17][18][19][20][21][22][23], most of them focused only on selected problems or the burden imposed by caregiving responsibilities, or were limited to short follow-up periods. Although most of the problems located in our research were social and emotional, this review provides significant evidence that FCs of cancer patients experience a large number of complexessocial, emotional, and health-related problems-as well as significant burdens related to caregiving responsibilities assumed during and after a patient's treatment for cancer.…”

“…Of the 192 studies, 164 articles were research-based studies, 12 were systematic reviews [12][13][14][15][16][17][18][19][20][21][22][23], 6 were more general reviews, and 10 were expert opinions [6,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] …”

“…Although a few earlier reviews provided some insight into FCs of cancer patients' problems, including physical and emotional symptoms, these reviews were not exhaustive; and they included only certain problems or aspects of the FC experience [12][13][14][15][16][17][18][19][20][21][22][23]. To date, no known review has addressed the full scope of problems faced by FCs of cancer patients nor included their perspective.…”

Autoeficacia específica para la Jubilación, Intenciones de retiro y Satisfacción vital en trabajadores mayores de 40 años.

“…El déficit en salud previo impone limitaciones a las personas para alcanzar y conservar buenos empleos, y por consiguiente para ahorrar suficiente dinero para la jubilación (Himmelstein, Warren, Thorne, y Woolhandler, 2005). Además los ingresos bajos limitan el acceso de las personas a tratamientos sanitarios costosos y por consiguiente, les impiden disfrutar de una mejor calidad de vida (De Judicibus y McCabe, 2005;Hanratty, Holland, Jacoby y Whitehead, 2007), lo cual vuelve a poner de manifiesto la circularidad de las relaciones entre salud y finanzas.…”

Chronic Health Conditions, Depression, and the Role of Financial Wellbeing: How Middle Age Group (45-64) and Older Adults (65-79) Differ?

“…First, as Kim and Lyons (2008) suggested, liquidating assets can take some time and patients (even those with significant assets) are inclined to experience financial difficulty. Second, the worries about how other family members will thrive with minimal wealth after their lifetime were the main sources of stress and anxiety for elderly patients (Hanratty et al, 2007;McGarry & Scoeni, 20065;Stoller & Mirowski, 2008).…”