Money matters: an analysis of advanced cancer couples' communication about financial concerns

Even for the insured, cancer treatment can be expensive and financially burdensome for families, especially in advanced disease.

To determine if advanced cancer patient-caregiver spousal dyads identified and/or discussed financial concerns.

Advanced cancer spousal dyads (n = 26) were asked to discuss their concerns (including finances) for 10 min. Discussions were audio-recorded and transcripts were analyzed for content and depth. We used the constant comparative analysis to analyze communication and demographic data from those who identified financial concerns relevant to cancer treatment.

Of the 26 couples identifying finances as a concern relevant to cancer, there was variability in perception of their overall financial situation, and roughly a third had discordant reports on the degree of financial concern. Thirty-five percent of dyads (n = 9) did not discuss finances during the audio-recorded discussions; for the other dyads, financial conversations varied in depth and breadth for specific concerns.

Couples were discordant in reports of concern about finances and perceptions of their financial situations. Even if finances were identified as a concern, many couples chose not to discuss financial concerns in depth. Some degree of shielding or avoidance between spouses may be beneficial, but couple financial discussions are important, especially when decisions may impact long-term plans. More research is needed to determine how to facilitate financial conversations to improve patient's and caregiver's well-being.