Ask CancerCare

March 2007 This Month's Topic: Caregiving Featured Expert: Aimee Gross, LCSW

Q. My dad was diagnosed with colon cancer last month. He and my mother live in another state than I do, and I have a family of my own so I can’t be there to help them out on a daily basis. What can I do to support them from so far away?

A. It is difficult when we want to be there for our loved ones but can’t. We can feel helpless and “out of the loop.” However, there are ways we can help, even from a distance. Here are some useful tips:

Help your parents with medical matters. Make sure your parents communicate regularly with your father’s doctor and that all their questions and concerns are being addressed. Ask your parents to sign a consent form allowing the doctor to share information with you in case you need to intervene on their behalf. If your parents are uncomfortable asking questions, send them a copy of CancerCare’s fact sheet, “Doctor, Can We Talk: Tips for Communicating with Your Health Care Team” .

Offer to help your parents with practical issues such as paying bills or making calls to their insurance company. Research information on resources and services for people with cancer. Volunteer to be the one to keep family and friends up-to-date on your dad’s condition, so that your parents don’t have to make so many calls and tell the story over and over. If your parents resist this kind of help, let them know that it would help you to help them. They are more likely to accept the assistance if they know it is helping you cope.

Give them emotional support. They will welcome your regular telephone calls and cards that let them know you are thinking of them and share what’s going on in your life. You many also want to suggest that they find additional emotional support through counseling or support groups. CancerCare offers telephone and online counseling and helps people locate face to face groups in their area.

Take care of yourself and your own family. People with cancer often worry about the impact their diagnosis has on their loved ones. You can ease your parents’ concerns by seeking out the same kind of emotional and practical help you want for them. Having your own life under control and your own family cared for will allow you to better support your parents and their needs. An excellent resource on this topic is the Family Caregiver Alliance’s booklet, Handbook for Long-Distance Caregivers .

Q. My grandmother has metastatic breast cancer. I’m worried about her, but even more so, I'm worried about my mom. She tries hard to be strong for everyone, but she is just so run down herself. She seems uncomfortable letting us, her children, be there for her. Can you offer any advice?

A. Have you told your mom what you told me – that you want to be there for her and help care for your grandmother?

Caregivers often feel they need to do everything themselves to make sure things get done as best as possible. This often leaves little room for others to help, and the caregiver ends up becoming exhausted.

Let your mother know that you are concerned and want to support her. Be clear about how you can help. Your mom might reject a general offer of help, but she might let you assist in specific ways, like driving your grandmother to an appointment or doing chores around the house.

If she still resists, ask her to think about how good it makes her feel to do things for her own mom. Then let her know that you would like to experience that good feeling, too, by supporting her. This approach works well with people who are caregivers by nature and have trouble accepting help themselves.

Your mom may feel uncomfortable sharing with you her feelings about her mother's illness. Still, you can support her emotionally by steering her toward helpful resources. One is CancerCare’s fact sheet, "Caring Advice for Caregivers: How Can You Help Yourself?" We also offer telephone and online support groups for caregivers, and can help you find support groups in your area.

Additional resources you might find helpful include:

• Strength for Caring: www.strengthforcaring.com/manual/14/215/cancer-caregivers.html
• Cancer Caregiving: www.cancercaregiving.com
• National Alliance for Caregiving: www.caregiving.org/index.htm
• National Family Caregivers Association: www.nfcacares.org

And, remind your mom that one of the best things she can do for everyone involved is to take care of herself by eating and sleeping enough, guarding her own health (taking medications, exercising, getting to doctor’s appointments, etc.), and taking time for herself.

Q. How can I give emotional help to my cousin who has cancer without saying something stupid or wrong that would upset her more?

A. It’s common to hear people with cancer say that their job is so much clearer than their loved ones’.  A person with cancer is supposed to follow the medical advice for treatment and do what the doctor says.  For the rest of us, it’s sometimes hard to know how to be helpful.

If you want to give your cousin emotional support but are concerned about broaching a sensitive subject, keep in mind that, while it’s upsetting, your cousin knows she has cancer.  It is her reality, and it’s okay to acknowledge that.  Too often, patients are denied the opportunity to talk about their feelings and fears, either because loved ones don’t want to upset them or are uncomfortable hearing about it themselves.  It is okay to ask your cousin how she is coping, and to let her know you are available to listen if she needs to talk. 

If you are unsure how to begin, CancerCare’s fact sheet, "What Can I Say to a Newly Diagnosed Loved One?" may help. Once that door is open, it’s up to her. Not every patient wants to or can discuss their feelings about their illness, so you don’t want to push. But those who do will appreciate your willingness to listen.  She may just need to vent, or you may be able to provide some practical information or resources to assist her during this difficult time.

People with cancer who do express their feelings and fears, can also get tired of talking about their illness. Your cousin may appreciate conversation about “lighter” topics, like favorite movies or T.V. shows, or that great book you or she just finished.  While it may seem trivial or frivolous to talk about these subjects, patients still want and need to feel “normal,” and to have a life that isn’t all about cancer, all the time.

Aimee Stefan Gross, LCSW, is an oncology social worker and program coordinator of caregiver services at CancerCare of New Jersey. Aimee provides support to patients and loved ones face-to-face, over the telephone, and online.

The questions and answers listed above are from the March 2007 Ask CancerCare feature.  New Ask CancerCare topics are introduced every month. 

If you have additional questions about caregiving, please contact CancerCare directly for information and guidance. CancerCare provides free professional support services, including counseling, education, financial assistance and practical help. These services are provided by professional oncology social workers. If you have a specific concern or question and would like to speak with an oncology social worker, please contact us at info@cancercare.org or 1-800-813-HOPE (4673).

For questions about medical issues, please visit Cancer.net, the patient information website of the American Society of Clinical Oncology (ASCO).