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.