Objective The prevalence of dementia and cancer has increased in recent years. The presence of dementia complicates the care of terminal cancer patients and affects their family caregivers. However, palliative care research seldom focuses on the family caregivers of patients with terminal cancer and dementia. This study aimed to evaluate the degree and factors of caregiver burden in cancer patients with dementia who died in hospice palliative care units. Methods: A nationwide cross-sectional survey was conducted among bereaved family members of patients with cancer who died in palliative care units. An anonymous self-report questionnaire was sent to bereaved family members, and they were asked if they were aware of the diagnosis of dementia. The short version of the Caregiver Consequence Inventory was used to measure caregiver burden. Results: The analysis included 670 bereaved family members. Of these, 83 (12.4%) were bereaved family members of terminal cancer patients with dementia. The caregiver burden was statistically significantly higher (3.61 ± 1.58 vs 3.22 ± 1.47; p < 0.036) among family caregivers of terminal cancer patients with dementia. Longer anti-cancer treatment duration (odd ratio, 4.63), poor mental and physical health of family caregivers (odds ratio, 2.05 and 2.20, respectively), pain (odd ratio, 1.72), and dyspnea (odds ratio, 1.67) were contributing factors for caregiver burden. Conclusions: Family caregivers of terminal cancer patients with dementia require care that considers the characteristics of the two serious diseases. Considering the goal of anti-cancer treatment and symptom relief may be a useful strategy for reducing caregiver burden.

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Background: Cognitive decline in cancer patients at the end of life makes it difficult for caregivers to manage symptoms and decide on cancer care. Objective: To define caregiver burden in relation to cancer patients with cognitive decline at the end of life. Methods: We use Walker and Avant’s eight-step concept analysis. We searched the MEDLINE, CINAHL, and Web of Science databases for relevant articles published between 2000 and 2020. Results: Caregiver burden for comorbid cancer and cognitive decline patients is defined as the pressure experienced by families in a multidimensional way due to the two deteriorating diseases in their process of facing the loss even before the deaths of patients and fulfilling their responsibilities as a family without knowing the patients’ own intentions. The antecedents included physical needs of caregiving, the cognitive decline of the patient, and whether the patient was dying. The consequences included caregivers’ physical and psychological health deterioration, decreasing caregivers’ coping abilities, and deterioration in the quality of death. Conclusions: This concept analysis indicated that the caregiver burden population should consider the characteristics of cancer and cognitive decline in interventions. Implications for Practice: Nurses should assess patients’ physical, psychosocial, and spiritual needs from various perspectives in advance to coordinate holistic care and prevent complications. Sharing the patient and caregiver’s history is important when discussing the patient’s wishes with the caregiver. Foundational: Caregivers in this population experience heavy responsibilities, multidimensional pressures, and the loss of patients before death. They are often required to be proxy decision-makers.