Wednesday, 10 October 2012

Caring for Cancer Patients At Home: A Guide for Patients and Families

Advances in cancer treatment and changing health care systems have led to shorter
hospital stays and sicker people being cared for at home. Non-medical caregivers find
themselves taking on roles that, just a short time ago, were carried out by trained health
professionals. This guide gives you general information about caring for a person with
cancer at home. It lists the more common problems people with cancer experience, signs
of problems you can look for, and some ideas for things you can do if problems come up.
The information given here is not meant to replace talking with your doctor or nurse. The
people who know your situation well can give you the information that you will need the

Anxiety and fear 

Anxiety (a feeling of worry or unease) and fear are common feelings that patients and
families sometimes have when coping with cancer. These feelings are normal responses
to the stress of cancer, and may be more noticeable around the time the cancer is first
diagnosed. Feelings of fear or anxiety may be due to changes in the ability to continue
family duties, loss of control over events in life, changes in appearance or body image, or
simply the shock of a cancer diagnosis. They may involve uncertainty about the future
and concerns about suffering, pain, and the unknown. Fears around loss of independence,
changes in relationships with loved ones, and becoming a burden to others may
overwhelm the patient and complicate family life.  Family members may have these feelings because they, too, are uncertain about the
future or angry that their loved one has cancer. They may feel guilt and frustration at not
being able to "do enough." Or they may feel overwhelmed by everything they now have
to do. Many caregivers feel stressed because of problems balancing work, child care, selfcare, and other tasks, along with more responsibility at home. All of this is on top of
having to worry about and take care of the person with cancer.
Sometimes, a person with cancer may become overly anxious, fearful, or depressed and
may no longer cope well with his day-to-day life. If this happens, it often helps the
patient and family to get help from a professional therapist or counselor.

What to look for 

• Feeling anxious
• Trouble thinking or solving problems
• Being nervous, agitated, irritable, or restless
• Feeling or looking tense
• Concern about "losing control"
• An uneasy sense that something bad is going to happen
• Trembling and shaking
• Headaches
• Being cranky or angry with others
• Tiredness or fatigue
• Trouble sleeping or restless sleep

What the patient can do 

• Talk about feelings and fears that you or family members may have – it’s OK to feel
sad and frustrated.
• Decide together with your family or caregiver what things you can do to support each
• Do not blame yourself and others when you feel anxious and afraid. Instead, look at
your emotions, concerns, and beliefs about what has been going on in your life, and
talk about those things.
• Get help through counseling and support groups.
• Use prayer, meditation, or other types of spiritual support.  • Try deep breathing and relaxation exercises several times a day. (For example, close
your eyes, breathe deeply, focus on each body part, and relax it, starting with your
toes and working up to your head. When you're relaxed, imagine yourself in a
pleasant place, such as a breezy beach or a sunny meadow.)
• Cut down on caffeine. It can worsen anxiety symptoms.
• Think about asking your doctor or nurse for a referral to a counselor who can work
with you and your family.
• Talk with your doctor about the possible use of medicine for anxiety.

What caregivers can do 

• Gently invite the patient to talk about his fears and concerns.
• Do not try to force the patient to talk before he is ready.
• Listen carefully without judging the patient’s feelings, or your own.
• Decide together with the patient what you can do to support each other.
• For severe anxiety, it is usually not helpful to try to reason with the patient. Instead,
talk with a doctor about the symptoms and problems you notice.
• To reduce your own stress, try suggestions from the list for the patient or use any
others that have worked for you in the past.
• Consider getting support for yourself through groups or individual counseling.

Call the doctor if the patient: 

• Has trouble breathing
• Is sweating, with a fast or pounding heartbeat
• Is feeling very restless
Note that some medicines or supplements can cause or worsen anxiety symptoms. If
anxiety gets worse after a new medicine is started, talk with your doctor about it.

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