While doctors fight to save the lives of cancer patients in intensive care, family members, partners and friends are often left carrying a heavy burden of their own, with research revealing widespread anxiety, depression, exhaustion and declining wellbeing among those supporting a loved one through a critical illness.
Published in the top-ranked journal Intensive & Critical Care Nursing, the review analysed nine international studies involving 924 participants and paints a bleak picture of the hidden impact on caregivers.
One study found 71 per cent experienced symptoms of anxiety and around half reported symptoms of depression. Almost all reported difficulties caring for themselves, while exhaustion, poor sleep and social isolation were common.
Caregivers also faced significant uncertainty about their loved one’s future and often felt they lacked information about what would happen after an ICU admission. Many were juggling caregiving, work and family commitments, and some continued to experience distress months after the critical illness had passed.
National Carers Week (11-17 October) aims to recognise and raise awareness of the more than 3 million Australians who provide unpaid care to a family member or friend.
Lead author and Flinders University PhD student Shalyn Rourke says the review highlights a group whose needs are often overlooked during a medical crisis.
“When someone with cancer becomes critically ill, the focus understandably turns to the patient, but family members and friends are often experiencing considerable distress themselves,” says Ms Rourke from the Flinders LiveWell Research Centre.
“Many caregivers are trying to navigate uncertainty about their loved one’s recovery while balancing work, family responsibilities and complex healthcare decisions. Too often, they are putting their own wellbeing aside in the process.”
Senior author and PhD supervisor Professor Catherine Paterson, a Professor of Cancer Nursing, says the findings suggest caregivers of people with cancer in ICU face unique challenges.
“Caregivers are not only dealing with a critical illness, but also the complexities and uncertainties that come with a cancer diagnosis,” says Professor Paterson, who is Co-Director of the Flinders LiveWell Research Centre , Caring Futures Institute.
“Our review suggests these circumstances can create emotional, informational and practical support needs that are not always recognised.”
The study also revealed a significant gap in understanding how critical care and cancer services work together to support caregivers. Despite the substantial burden identified, only two studies explored the perspectives of healthcare professionals and the role of the multidisciplinary team in delivering coordinated support.
Professor Paterson says there is an important opportunity for health services to better identify and respond to caregiver distress.
“Nurses and the wider multidisciplinary team are well placed to look out for signs of distress in caregivers and ensure they receive appropriate support and include them in follow-up care after an ICU admission,” she says.
“Better communication between intensive care and cancer services could help ensure caregivers receive the information and guidance they need during what is often one of the most difficult periods of their lives.”
The researchers say further research is needed to better understand how healthcare services can deliver coordinated, family-centred care that supports not only patients, but also the people who care for them.
“These caregivers play a vital role in a patient’s recovery and ongoing cancer journey and if we want to improve outcomes for patients, we cannot overlook the wellbeing of the people who support them,” concludes Professor Paterson.
The article, Quality of life and supportive care among informal caregivers of people with cancer during a critical illness in the ICU: A mixed methods systematic review, by Shalyn Rourke, Rachel Bacon (University of Canberra and Central Queensland University), Ria Joseph, Murray R. Turner (University of Canberra), Frances Lin and Catherine Paterson. DOI: 10.1016/j.iccn.2026.104497
