Associations of financial hardship with suicidal ideation among bereaved cancer caregivers

Abstract

Purpose

To examine associations between financial hardship and suicidal ideation among bereaved informal caregivers of cancer patients.

Design

Longitudinal cohort study

Sample

173 informal caregivers of advanced cancer patients

Methods

Caregivers were interviewed a median 3.1 months before and 6.5 months after the death of the patient they cared for. Logistic regression models estimated associations between caregiver-perceived pre-loss and post-loss financial hardship due to the patient’s illness and post-loss suicidal ideation.

Findings

Suicidal ideation was identified in 12% (n = 21) of the sample pre-loss, rising to 20% (n = 34) post-loss (p=.049). Pre-loss financial hardship (OR = 3.4, 95% CI = 1.5–7.4, p=.002) and post-loss financial hardship (OR = 3.7, 95% CI = 1.7–8.2, p=.001) were each bivariately associated with post-loss suicidal ideation. In multivariable models adjusting for pre-loss suicidal ideation, psychiatric diagnosis, and spousal relationship to the patient, post-loss financial hardship remained significantly associated with post-loss suicidal ideation (AOR = 3.6, 95% CI = 1.4–8.8, p=.006).

Conclusion

Among a cohort of cancer caregivers followed from active caregiving into bereavement, post-loss financial hardship was associated with suicidal ideation in bereavement.

Implications

Economic policies that financially benefit caregivers may represent promising strategies for preventing suicidal thoughts and behaviors.

Keywords:

• Cancer
• caregiving
• financial hardship
• suicidal ideation

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [HGP], upon reasonable request.

Additional information

Funding

This work was supported by the National Cancer Institute under Grants CA106370, CA197730, and CA218313, the National Institute of Minority Health and Health Disparities under Grant MD007652, the National Institute of Nursing Research under Grant NR018693, the National Institute on Aging under Grant AG049666, the National Institute of Mental Health under Grants MH121886 and MH063892, The WITH Foundation, and the National Center for Advancing Translational Science under Grant TR002384.