Comparing adult-child and spousal caregiver burden and potential contributors

Anny T.H.R. Fenton, Nancy L. Keating, Katherine A. Ornstein, Erin E. Kent, Kristin Litzelman, Julia H. Rowland, Alexi A. Wright

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background: Adult-children caring for a parent with cancer comprise a significant segment of caregivers. Yet less is known about adult-child caregivers, their burden, or caregivers' and patients' gender's impact, which may differ from the well-studied spousal caregiver. This knowledge gap may hinder efforts to ameliorate adult-children's caregiver burden. Methods: We analyzed caregiver surveys from the Cancer Care Outcomes Research and Surveillance Consortium, a multi-regional population-based study of patients with colorectal or lung cancer. Using t tests and multivariate regression models, we assessed whether adult-child and spousal caregivers' caregiving responsibilities and social/emotional and financial burdens differed and used structural equation models (SEMs) to examine mediating factors. Results: Compared with spouses/partners (N = 1007), adult-children (N = 227) spent less time caregiving (14 vs 23 hours/week; P <.001), but experienced higher social/ emotional burden (P <.01). In models adjusted for objective caregiving burden measures and demographics, adult-children's social/emotional (P <.05) and financial burdens (P <.01) were greater than spouses'. Poor communication quality was associated with greater social/emotional burden for both groups (P <.05). SEMs indicated that gender concordance between caregivers and patients (eg, daughters caring for mothers) and caregiver employment increased the difference between adult-child and spouses' social/emotional burden, whereas caregiver-patient relationship quality reduced it. Conclusions: Adult-children spend less time caregiving than spouses/partners, but have higher social/emotional and financial caregiving burdens, partially due to adult-children's employment, caregiver-patients' gender concordance, and relationship quality. Gender concordance's contribution to greater social/emotional burden adds important context to prior findings, indicating female caregivers experience the most burden. Interventions that improve caregiver-patient communication may reduce both adult-child and spousal caregiver burden.

Original languageEnglish
Pages (from-to)2015-2024
Number of pages10
Issue number10
StatePublished - 15 May 2022


  • caregiver preparedness
  • caregivers
  • caregiving burden
  • communication
  • families
  • financial burden


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