Ask CancerCare
December 2008 This Month's Topic: Coping with Cancer During the Holidays Featured Expert: Richard Hara, CancerCare's Program Director of Online Services |
Q. My brother passed away this year and I was his caregiver. He was 42. I am devastated and do not know how to cope this holiday season.
A. The holidays often underscore the absence of a lost loved one and all the feelings associated with that void. In addition, the people around you might not recognize the depth of your grief—as they might if you had lost a partner or a child—and may not be providing the support you need.
The holidays are a time for giving, so give yourself the gift of acceptance: acceptance not so much of the loss itself, but that your grief is one step in the healing process. It's natural that remembering your brother at this time brings sadness and pain. You don't have to fight this. Cry if you need to, tears won't ruin the holiday. But don't hide yourself away with your grief: as the saying goes, a grief shared is a grief diminished.
It's also ok to have fun during the holidays. Although this might feel like a betrayal of the memory of your brother, it isn't. Working through your grief and trying to live life to the fullest—aren't you doing what he would have wanted you to? Remembering your brother on special days is also way to honor him. He can be there "in spirit" through a symbolic ritual such as lighting a candle at a family dinner in his memory, or planting a tree on New Year's Day: do anything that has personal meaning to you and your positive memories of him.
Grief is a normal response to loss. Tackle what you feel up to doing during the holidays, but take care of yourself and have others respect whatever limits you might place. For a more detailed checklist of things that can help you through the holidays, see this publication from the American Hospice Foundation 
. For more information about the grieving process generally, see the summary provided by the National Cancer Institute, or check your bookseller for How To Go On Living When Some One you Love Dies, written by one of the foremost experts on grief, Therese A. Rando.
Q. As caregiver for my husband, a pancreatic cancer patient, I have no interest in the Christmas holiday. This is our second year and last year we had just gotten the word. A year later I still have no interest. I know this is a disappointment to our adult children and our young grandkids don't understand why I just don't care about shopping, etc. What can I say to them to tell them I love them but I am just so sad, other than just that?
A. As far as your grandchildren are concerned, it sounds like they know something is wrong and are trying to find out exactly what. If they haven't been told about your husband's cancer, please consult with a social worker or another member of your husband's treatment team about how to discuss cancer with children in an age-appropriate way. You can also get some pointers from our CancerCare Connect booklet, Helping Children When a Family Member has Cancer . In the meantime, it's wonderful to reassure the grandchildren that you love them, and that although you're feeling down these days, you're doing what you can to make it a good holiday for everyone.
I don't know how things stand right now with your husband's treatment and the extent of your caretaking duties, but it may be that you're feeling "burnt out." Even though it's the holiday season, it's hard to feel like you can take "time off" from cancer. I wonder if your lack of interest in shopping and the trappings of Christmas is a signal that you need to replenish yourself physically, emotionally and spiritually. My suggestions for you are not so different from the ones I gave previously to patients coping with the holidays: Keep expectations realistic; Let others help, even if you're still the principal organizer of holiday activities; Set priorities and pace yourself; and Share your feelings with others.
Try not to dwell only on the cancer: remember that the meaning of the holidays is in certain ways already expressed through the care you are giving. And although you're struggling with feelings of sadness and loss, you are still permitted to enjoy the gifts of the present: to celebrate not only a grand religious tradition, but also the moments of joy and gratitude for being with the people you love.
For more general tips on how to support yourself as a caregiver, see the previous feature on caregiving in the Ask CancerCare archive, with links to other resources and publications, or our Fact Sheet, "Caring Advice for Caregivers: How Can You Help Yourself?"
Q. I was diagnosed with breast cancer a few months ago and I don't feel much like celebrating. I'm worried I'll be a downer for my family and I'm not sure how to act.
A. Adjusting to the reality of a cancer diagnosis and the changes to your life takes time and energy. It makes sense that you don't feel like celebrating. You're probably experiencing many feelings: some negative, such as uncertainty about the future, and also some positive, such as gratitude for the love and support of family and friends. It's okay to not feel up to celebrating, but you should try as much as you can to not let your fears about being a "downer" keep you from staying connected with the important people in your life. Here are some practical tips I think could be helpful to you:
- Keep your expectations realistic
Know your physical limitations and give yourself extra time to rest as needed; anticipate that strong emotions will hit you unexpectedly, and give yourself permission to be less than "joyful" all the time. - Delegate — let others help
Creating a list of tasks you can ask others to take on for you accomplishes two things: it helps distribute responsibilities in a more manageable way, and people feel more comfortable when given something specific to do to help. - Save your energy for the important stuff
In other words, prioritize and pace yourself. If you need to turn in early, or aren't able to eat in your accustomed way, just let people know. Everything doesn't have to be done all at once: enjoy what you can now, and look forward to enjoying more in the future. Maintaining holiday traditions is important, but that doesn't mean they can't be altered or replaced with new ones. - Share your feelings with others
Don't be afraid to express your feelings and concerns to family and friends. But consider in advance how much you feel comfortable sharing, and how much the other person may be able to hear. These are judgment calls, and not easy to make, but remember that the goal is not so much about imparting information, as it is supporting and enriching relationships.
For other, more specific tips for coping during the holidays, please read CancerCare's fact sheet, "Coping with Cancer During the Holidays" .
Other sources of information are available from the American Cancer Society website and Cancer.net, the patient information site of the American Society of Clinical Oncology.
Richard Hara, Ph.D., LCSW, is director of online services at CancerCare. He specializes in lung cancer patients, post-treatment survivors, and family caregivers. He is a co-author of 100 Questions and Answers about Caring for Family or Friends with Cancer, a guide for caregivers on coping with the practical and emotional concerns raised by cancer.
Ask CancerCare Archive (questions and answers from previous months)
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