Caregivers and legal barriers: navigating care of a family member diagnosed with cancer
Krista Y Chen, Amanda L Blackford, Monica F Bryant, Joanna F Doran, Nicholas J Odom, Andres Azuero, Gabrielle B Rocque, S M Qasim HussainiAbstract
Caregivers of patients with cancer frequently coordinate care while navigating insurance, employment, financial, and benefits systems, yet their legal and administrative needs remain poorly characterized. We analyzed caregiver-initiated consultations in national non-profit organization’s Legal & Financial Navigation Program from 2021 to 2024. Among 1,091 consultations, caregivers were predominantly female (67.7%) and working age (19-64y, 60.8%); 10.9% lived in a different state than the patient. Caregivers reported 1,889 legal concerns, most commonly involving health insurance (32.1%), finances (24.0%), disability insurance (14.2%), and employment (11.8%). More than half (51.1%) reported multiple concurrent legal concerns. In adjusted analyses, residence in the South was associated with higher odds of multiple barriers than the Northeast (odds ratio [OR] = 1.60), whereas Marketplace, Medicaid, and Medicare coverage were associated with lower odds relative to employer-sponsored insurance. These findings support caregiver-focused screening, education, and legal navigation as components of supportive oncology care.