The population in the western world is aging and the care of elders with cancer is a brewing major public health problem. The psychosocial problems will also increase at a policy and at a personal level. There are several frequently encountered situations I have encountered in treating elders and their families in groups and individual sessions. The first conflict confronted relates to transition in care related to health status: 1) When is a caregiver necessary, and who decides? The elderly independent person who lives alone and adamantly demands to remain there is a source of distress to adult children who are fearful of falls and poor management of medications, while the elder says,” I don’t expect to live forever—leave me alone”. 2) When the widow or widower lives in one city and the caregiver is a son or daughter who lives a distance away and must juggle young family and care of an elderly parent—the problems of the ”sandwich generation” 3) When the spouse (usually a wife) is alive and is the informal caregiver but becomes exhausted physically and mentally with care of the elder who may or may not be cooperative, resulting in anger and frustration. “We will be married 60 years in July—if I don’t strangle him first”. 4) When there is no family informal caregiver and paid home health aides serve the role. This can be a remarkably positive experience or a source of further isolation for the elder and frustration for the aide who doesn’t understand, often due to differences in language or culture. 4) When the level of care requires an assisted living arrangement and caregivers are apt to change and have a less personally close relationship with an obligation to the patient and to the institution. Anecdotes will illustrate each area and discussion will outline approaches to the problems.

"This abstract is part of Symposium proposal: “In sickness and in health”: Coping and needs of spouses and children caring for adult and older cancer patients, clinical observations and research data. Coordinator: Gil Goldzweig