Articles of Interest
Written by: Shelley Klahs
-Supporting a loved one during a critical time -
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When a loved one is diagnosed with a serious illness, it is often unexpected and unbelievable. People ask, “Are you sure the tests are correct? How can this be happening?” Initially, take some time to recognize how you feel and acknowledge that this is difficult for both you and the patient. Stating, “I don’t know what to say,” is ok. Just admitting this and being with them physically, over the phone or in a card or letter is supportive. Your loved one needs someone to listen to them as they talk candidly and likely aren’t expecting family and friends to have the answers to the hard questions. Not everyone can help and be a caregiver in the same way. Some people would be terrified of having an emotion laden conversation with someone they love but try to do that anyway. It does not have the intended effect and often leaves the patient feeling unheard and rejected because the patient can sense the undercurrents. Offer support in a form that feels comfortable to you. Offer to pick up grocery items the next time you are headed to the store. Are there opportunities to provide transportation to appointments or to pick up children from activities? Are you more comfortable in the kitchen than in an intimate conversation? You can show support by dropping off a meal or snack. Caregivers and patients will likely experience the normal stages of grieving. The stages of grief are experienced differently by people and some people may not experience all the stages or experience the stages in this order. Allow yourself to feel these stages of grief and to work through them. Grief that is not resolved, eventually may be revealed in other ways. Through this process, it is important to understand your own needs to heal and how to best support your loved one.
Ways to help:
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- Schedule visits when it is convenient for the loved one.
- Show compassion. The most important thing you can do is to let your loved one know you are there. Listen to them so they can express their thoughts and feelings without judgment or being told to not think like that. Be present and accept where your loved one is in the process of accepting the situation on their timetable. Remember they are still the same person you have known but now have a difficult challenge to deal with.
- Keep eye contact when talking/listening to them. Allowing them to verbalize their
feelings is often helpful enough. You do not have to have the answers, and many times there really aren’t any definitive answers.
- If they request privacy, respect that. Ask what type of contact and frequency they would find helpful and then honor that.
- Requesting and receiving help can be difficult for people who value independence and are not used to asking. Instead of asking if you can grocery shop for them, it may be easier if you say “I will be making a Target run this afternoon. What do you need for me to pick up for you?” Do not assume that your loved one cannot do things. Likely they do not want to be seen as an invalid. Suggest taking them to appointments so it is not so boring for them to sit alone waiting.
- If they are feeling up to it, they may enjoy participating in an activity they usually enjoy, such as going for a walk or a coffee date. Do they have pets and if so, are there pet care responsibilities that you could offer to do? No matter what the pet, there are bathroom cleanup tasks that should not be done by someone with a weakened immune system. Walking a dog can be an enjoyable form of exercise for a caregiver but be exhausting for someone in crisis or going through medical treatment. Ask your loved one the questions you may have about their situation or treatment. While it is tempting to learn everything that Dr. Google has to offer, don’t go there. Your loved one is the expert and won’t likely respond well to a friend or family member’s sudden accumulation of knowledge coupled with an overwhelming desire to share it.
Below is a summary of the 5 stages of grief:
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Denial. The news is shocking. Often the information is too much to absorb and feels overwhelming to both patients and loved ones.
Anger. This is a natural response to distressing news and often involves blaming someone or something. Sometimes the focus of anger is specific –the doctor who should have discovered the symptoms sooner, the patient for not going to their doctor sooner, the cost of medical care creating a financial barrier. When anger is ignored, it is often revealed in other ways– becoming angry because the person in the 10 items or less lane has 11 items, finding it unforgivable that the store doesn’t have the item you need, finding anything less than perfection being unacceptable in the people around you.
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Bargaining. There is an urge to recapture a sense of control and a desire to impact the future outcome. We have all done this. Who hasn’t promised to drive the speed limit and leave earlier the next time as they cruise through yellow lights while crossing their fingers that there are no police officers in sight? What patient hasn’t at least had urges to bargain, offering to exercise daily or give up self-destructive habits, if only the upcoming test results will be favorable.
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Depression. Depression is a normal response to life-changing news and evidence of it can be experienced in many ways. The caregiver or the patient may have difficulty sleeping or not be able to focus on anything. Weight changes can happen and sometimes people experience physical symptoms like headaches, loss of appetite, or muscle aches. While some depression is a normal part of working through the stages of grief, contact your care provider if depression is interfering with daily life. Ask yourself if you or your loved one are taking care of your basic needs – bathing, eating, sleeping a reasonable amount of time each night, taking meds as prescribed? Are you or your loved one having suicidal thoughts or thoughts of self-harm? Can you or your loved one carry on a conversation that is rational? If there are any concerns in these areas, contact the doctor and make him aware of the concerns.
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Acceptance. In this final stage of grief, both the pain of loss and the joy of living or knowing the person, can coexist side by side. The person no longer bursts into tears when they hear a song that reminds them of the person. Acceptance is the ability of the person to live with the loss and go on.
Grief. Not everyone works through the stages of grief in the same order or at the same speed. Research suggests “uncomplicated grief” requires approximately two years to process. Grief is rarely “uncomplicated” but lessens over time while “complicated” grief either does not improve or worsens over time. Complicated grief should be brought to the attention of the medical team.
Actions to avoid:
- Don’t respond to their news by being a cheerleader, saying “You will be fine” or “Think positive! Positive thoughts are Stronger than cancer” These types of statements often apply pressure to a situation rather than offer hope or comfort. If you have experienced a similar diagnosis at some point in your life, don’t state, “I know how you feel.” You don’t because you are a different person even if the diagnosis is the same.
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- Don’t place blame for the diagnosis based on past behavior such as smoking, not
participating in regular exams, or eating in a way that may not be the healthiest diet.
Judging their behavior or their decisions isn’t helpful and doesn’t change the situation. Recognize that your opinions are your own and unless solicited by the loved one, aren’t relevant to the situation.
- Don’t judge the choices they make regarding the treatment options offered by
providers.
- Don’t offer advice based on your online research.
- Don’t treat them differently than you did before or assume they can't provide self-care.
- Don’t feel the need to talk during every moment of your visit. Just having a friend or family member present may provide the comfort that they need without any words being exchanged.
- Don’t feel the need to have answers. Don’t feel the need to focus every conversation on the diagnosis unless your loved one wishes to talk about it; talk about topics you often have before the illness. If/when appropriate, engaging in laughter may be helpful to cope or simply offering a shoulder to cry on and a hug. Relationship dynamics may change and exaggerate moods in either direction during this emotional time.
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These tips and more can be reviewed at the following links:
Healthline.com
Cancercare.org
Cancerresearchuk.org
amp.cancer.org
nm.org
percihealth.com