Background : The elderly (aged 60+ years) are the most vulnerable group to pancreatic cancer due to frequent comorbidities and mortality globally. Potential curative treatment is surgical resection, either by pancreaticoduodenectomy (the Whipple procedure), total or by partial pancreatectomy although long-term survival is very poor. Indonesia is entering an aging society while the Elderly with independence barriers reached 3.7% (Basic Health Research, MoH (2018)). The elderly with pancreatic cancer is very dependent on the caregivers' existence to maintain their QoL. However, certified informal caregivers are not available in Indonesia, yet.

Methods : This study uses the 5th wave of the 2014 Indonesia Family Life Survey (IFLS), longitudinal and large-scale data. The IFLS consists of individual, household, and community data covering 24 of 34 provinces in Indonesia. This study aims to explore how the availability of caregivers in maintaining the Elderly QoL post Pancreatic Adenocarcinoma Surgical Resection with Dementia comorbidity.

Results : Indonesian elderly reach 10.8% of the total population and 48% of them have chronic diseases. 70% of pancreatic cancer patients recorded in Indonesia are at Elderly age. As many as 34.7% of the elderly with post Pancreatic Adenocarcinoma Surgical Resection were identified as having symptoms of dementia with moderate to severe severity which were assessed using the mini-cognitive test scoring. The elderly needing long-term care due to these health conditions reaches 9.7% and 88% of them do not have caregivers or take care of themselves. Only less than 1% of the elderly are cared for by paid caregivers and are concentrated in urban areas. The majority of the elderly are cared for by their families or tend to age in place or community. 36% of post Pancreatic Adenocarcinoma Surgical Resection elderly people with dementia are holders of social protection programs so they benefit from health insurance and government social assistance. Using the Geriatric Depression Scale (GDS) it is known that the percentage of post-Allo-HSCT elderly with dementia who has caregivers with mental health problems is lower than respondents who do not have caregivers.

Conclusions : As a country that will become the second-largest Silver Economy in the world after China, Indonesia to meet the availability of certified informal caregivers with standardization modules and training. Furthermore, expanding the coverage of health insurance for the provision of caregivers is a top priority because it mitigates mental health problems.