Dying of cancer in Italy: impact on family and caregiver. The Italian Survey of Dying of Cancer.
OBJECTIVE
To describe the effect of terminal cancer on the patient's family, finances and daily life.


METHODS
A cluster sample of 2000 adults (> or = 18 years old) who had died from cancer, and who were representative of Italy, was studied. 1900 caregivers were identified and 68% responded to a post-bereavement survey. Caregivers included the patient's child (46%), his/her spouse (31%), other relatives or friends (20%) or a health professional (3%). The median age of a caregiver was 54 years and 69% were females. During the last 3 months of the patient's life, 44% of caregivers reported difficulties in their regular employment.


RESULTS
Of the 68% of families who had to pay for some of the care, 37% had to pay for drugs, 36% for nursing and assistance and 22% for physicians. Paying for care was more frequent in the south of Italy (OR 2.5; 95% CI 1.0 to 6.3) and when the patient was a housewife (OR for unit increase 2.7; 95% CI 1.6 to 6.1). To cover the costs of patient care, 26% of families used all or most of their savings. Economic difficulties were greater in the south of Italy (OR 3; 95% CI 1.8 to 5.1), for female caregivers (OR 1.4; 95% CI 1.0 to 1.9) and for disadvantaged patients. The duration of time the patient was completely dependent strongly determined the effect caregiving had on their regular employment and on the family's financial situation.


CONCLUSIONS
Although in Italy families are responsible for a small percentage of the overall costs of patient care, the effect of cancer on savings and daily life can be substantial. Strong geographical and gender differences emerged from this study.
Giorgi Rossi
Paolo
P
Agency for Public Health, Lazio Region, via di S Costanza 53, 00198 Rome, Italy. giorgirossi@asplazio.it
Beccaro
Monica
M
Miccinesi
Guido
G
Borgia
Piero
P
Costantini
Massimo
M
Chini
Francesco
F
Baiocchi
Diego
D
De Giacomi
Giovanna
G
Grimaldi
Maria
M
Montella
Maurizio
M
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D004651:Employment; D005190:Family / Q000523:psychology*; D005249:Fees and Charges; D005260:Female; D006699:Home Care Services / Q000191:economics; D006701:Home Nursing / Q000191:economics; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics / Q000401:mortality / Q000523:psychology*; D010166:Palliative Care / Q000191:economics; D011159:Population Surveillance / Q000379:methods; D018454:Spouses / Q000523:psychology; D013727:Terminal Care / Q000191:economics