Caregiving Burden and Psychological Vulnerability of Young Adult Caregivers in Parental End‐Of‐Life Cancer Care: A Nationwide Bereavement Study

OBJECTIVE: With the aging population, family caregivers, including young adults, play an increasingly important role in supporting patients with cancer. This study compares the caregiving burden and psychological vulnerability faced by individuals caring for parents with terminal cancer during end-of-life (EOL) care and bereavement among three age groups: young adult caregivers (YACs), adult caregivers, and older caregivers. METHODS: This cross-sectional study entailed a secondary analysis of Japanese national bereavement survey data. Data from bereaved family members who had cared for parents with cancer were used, and YACs (18-25 years) were compared with adult (26-39 years) and older (≥ 40 years) caregivers regarding caregiving burden, mental health, and depressive or grief symptoms. Statistical analyses included descriptive summaries and logistic regression to identify group differences. RESULTS: From the original dataset, 18,145 parent-caring participants were analyzed, including 43 YACs. Compared to older caregivers, YACs reported higher psychological vulnerability, with significantly poorer mental health during the final week of caregiving (64.3% vs. 36.3%, OR: 3.15; 95% CI: 1.70-6.08) and higher depressive symptoms 1-2 years post-bereavement (29.3% vs. 11.9%, OR: 3.06; 95% CI: 1.50-5.86). Moreover, YACs showed a lower mean score for personal growth than older caregivers (4.5 vs. 5.0 difference: -0.5, 95% CI: -1.0 to -0.1) despite a similar caregiving burden across groups. CONCLUSIONS: Notably, YACs face distinct challenges during EOL care, including increased psychological vulnerability and limited recognition of personal growth. Tailored interventions, including early mental health screening and resiliency-building strategies, are critical for effectively supporting this population.