A serious illness (for example, cancer) is a huge challenge for both the patient and his loved ones. How to properly support a person and help him get out of a critical situation?
Our expert is a clinical psychologist, a member of the International Society of Oncopsychologists and the International Association of Psychiatrists, the Multinational Association of Professionals Helping Cancer Patients, and the European Association of Clinical Communications, a specialist in the register of the British and American Psychological Associations Evgenia Ananyeva .
If you ask people who have survived cancer or another long-term dangerous illness whether their social circle has changed since they became ill, the answer will most often be “yes, it has narrowed significantly.” No, we are not talking about blatant cases when patients are abandoned by their other halves and betrayed by friends, although this, alas, does happen. But, as a rule, the circle of friends thins out because those around them do not know how to properly provide support without harming or offending. An oncologist can teach you all this.
Shock, denial and beyond
A person who has received difficult news (in particular, a diagnosis of cancer) experiences 6 stages. In psychology they are well known: shock, denial, bargaining, anger, depression and, finally, acceptance. However, these stages do not always go in order; sometimes they alternate, mix, and repeat again and again. Sometimes the stages replace each other quickly, and sometimes a person lingers on one or another for a long time. The task of an oncology psychologist is to help the patient overcome all these stages as quickly and easily as possible in order to reach acceptance and awareness of the diagnosis. Then the treatment will be more productive.
But it turns out that not only the patients themselves, but also their loved ones go through the same stages of experiencing grief. And it is important that on this path they do not lag behind the patient himself (and do not rush him). Because if a person has already accepted his diagnosis and is ready to fight, and his relative is stuck at the stage of anger or bargaining and pulls his loved one either to sorcerers and healers, or to fortune-tellers, or to a temple, such support will only do harm.
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How to reassure a loved one with cancer?
Today, everyone who gets cancer is openly told the diagnosis; another thing is that the human psyche is protected, and much of what the doctor says is not remembered and is transformed. What the patient remembers and understands, family members can only find out from him, so we need to talk. Pretending that everything is fine and nothing has changed in the life of the family is very short-sighted, because tomorrow you will have to live differently, with a focus on medical procedures.
It is necessary to talk openly with each other, you can avoid an important conversation by avoiding discussing the disease, only then everyone has to hide their eyes, which only worsens the family atmosphere and aggravates anxiety. Let your loved one with cancer speak out, then you will understand what is important to him these days, what he worries about most, what he really wants, and together you will find a solution to all the issues.
It is useless to console, let alone assure, that cancer is a diagnostic error. Pity angers the sick person and demoralizes him. The best consolation is a discussion of the present and future life, certainly with perspective and very substantively. Clarity of possibilities and prospects improves the mood of the patient and his family.
We wanted the best
Fighting a serious illness is a long journey. Along this path, the patient’s loved ones can make a lot of mistakes. Here are the most common ones.
Mistake No. 1. Being offended . A person who is seriously ill may behave inappropriately. And not just a day or two, but perhaps quite a long time. Medicines, stress, fear, “side effects” from toxic “chemicals” can cause depression in the patient, from which he will sometimes fall into apathy, and sometimes into aggression (both in words and even in actions). Those close to you need to get into the situation and try not to be offended. But this does not mean that the diagnosis allows a person to behave as they please. Gently but intelligibly, those around him should indicate to the patient that he is crossing boundaries in his behavior.
Mistake No. 2. Decide everything for the patient . Sometimes relatives not only make all treatment decisions for the patient themselves, but even hide the diagnosis from him. This is completely wrong! On the contrary, it is necessary to maintain in him a sense of self-confidence and control over his life. A person must understand that he and his opinion are taken into account, that he is important, that he is still alive, finally! You need to help him stay active: ask his advice, opinion on some issue, talk about those topics that previously inspired him: for example, about his hobbies, interests. There is no need to specifically amuse and entertain the patient, but you need to encourage him to speak out himself, motivate him to set topics for conversation.
Mistake No. 3. Hushing up problems . It is difficult and scary to speak openly about difficult topics that often arise during treatment, but they cannot be avoided, since it is critical for the patient to be heard and understood. Therefore, in case of such difficulties, it is better to contact an oncological psychologist in order to remove your own fears and thereby help your loved one.
Mistake #4: Giving medical advice about treatments, diet, etc. Just don't mind your own business.
Mistake No. 5. Imposing your thoughts and emotions on the sick person . Another person has the right to his attitude towards everything that concerns him. It is enough to simply tell him your position on a specific issue, but there is no need to convince him. And get angry too.
Mistake No. 6. Giving all your strength, forgetting about yourself . You need to understand that cancer is not a quick story, so it’s better to tune in to a marathon rather than a hundred meters. You will have to reconfigure your own life in order to be able to help long-term and to the required extent. To maintain strength, you need to be attentive to your own needs. It is very difficult to help when you yourself are not completely fine! Just like on an airplane, remember: first put the oxygen mask on yourself, then on the child.
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The diagnosis has been made, what to do next?
Next, everyone needs to calm down and sort out the life of the patient’s family “on the shelves.” Everything has already happened - the tumor has grown, there is no point in analyzing the reasons for its occurrence. Causes of cancer - past, present - long and difficult treatment. Not abstract therapy, but a specific operation and hospitalization date for the surgical stage, or multi-week chemotherapy and radiation treatment.
It is necessary to discuss with a relative with cancer who will help with getting a bulky bag to the emergency department on the day of hospitalization, who will visit and on what days. Who will help me go to chemotherapy several times a week or attend radiation sessions every day? Finally, how will the family function during this period, who will take responsibility for the children or elderly parents left at home, who will take care of the dacha, who will walk the dog.
Everything is very specific and with a detailed discussion of practical issues, because each time it becomes more difficult for working relatives to ask their superiors to accompany their loved one to a medical institution. It is likely that assistance will have to be distributed to all family members.
It seems that the first days after receiving the diagnosis are not the best time to discuss family life. But it only seems, firstly, that this forced distraction from painful thoughts will eliminate the “funeral” mood. Secondly, the cancer patient sees how important his opinion is to the family; one cannot “go limp” if many problems cannot be resolved without it. Thirdly, it is by their desire to help that loved ones demonstrate their love. For the patient and his family, discussing plans for the near future is an important job that eliminates unnecessary thoughts.
Vain words
Many loved ones of sick people simply do not know how exactly to support them so as not to make things worse. Therefore, it is sometimes easier for them to withdraw themselves. By the way, this is exactly how you shouldn’t “support”. It is forbidden:
Blame . For example, say: “Yeah, I didn’t go to the examinations on time, but I told you that I should have” or “Well, I finished smoking, and I warned you.” Even if the accusations are true, they are useless now.
Speak empty words . Among these: “Hold on,” “Everything will be fine,” “I know you can handle it.” Instead, it is better to say: “I will be there, I will help you.”
Devalue experiences . You can’t say: “Yes, this is all nonsense,” “It can be worse.” For a person with a serious diagnosis, nothing could be worse.
Compare . You should not say: “I understand you,” “I know how you feel.” Anyone who has not experienced this cannot feel the same. For exactly the same reason, you should not cite the stories of acquaintances as examples - they relate not to him, but to others and will not help him in any way.
Say : “If anything happens, please contact me.” Many people find it difficult to ask for things, even when they really need them, so it's best to be specific. For example, you can offer a person to go to the store for him and buy his favorite cakes, or to take him for a walk with his child or dog, or offer to clean the apartment. Often, to provide true support, it is enough to simply be physically there, even silently. Just go to the doctor together, watch a movie, take a walk.
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What can you do to help a relative with cancer?
Help with household issues, take charge of organizing his meals. Try to do it beautifully; healthy people often don’t really care what the food looks like or what it’s served on. A patient receiving chemotherapy is bothered by odors, and his appetite decreases and becomes distorted. Ask what a loved one with an appetite wants, and serve it to him in a small portion and on a beautiful plate, water - not in a mug, but certainly in a glass goblet. Beautiful presentation stimulates the appetite, as has been demonstrated hundreds of times in television advertising. Your attention and love will be appreciated, even if the patient is capricious, you will know for sure that you did everything possible for him.
Find time to go with a sick relative to an appointment or get tested; if your strength allows, then after the visit, take a walk, go to the cinema, sit in a cafe. It is very difficult psychologically to live in a closed circle “home-hospital-home”; from time to time it is simply necessary to break the confinement, and it is better to do this every week. The prospect of a pleasant event brightens the waiting period; a person becomes mobilized and sees the day much more positively.
The primary therapy program takes several months, which means you have to think about money. Payment for sick leave will happen only after it is closed, and unforeseen expenses will inevitably increase. Perhaps one of the family members will have to reconsider their vacation plans and cancel the trip. A small personal sacrifice will not only save money for more important matters, but will show the sick relative that he can completely rely on you, because his interests are a priority for all family members.
Don't destroy yourself
To control their own stress, relatives and friends of the patient should try:
- think positively, remain calm, stable;
- If possible, continue to do those things that bring joy and pleasure, do not give up your hobby;
- learn to relax (with the help of meditation, yoga, qigong/tai chi);
- do physical exercise - it will help cope with stress;
- eat a balanced and regular diet;
- get enough sleep
- and rest;
- give up alcohol;
- if necessary, consult a psychologist;
- communicate in person and online with those who also have seriously ill loved ones.
How to help a patient accept changes in appearance?
Active treatment does not make anyone look better, surgery and chemotherapy deplete one’s strength, facial features become sharper, the skin becomes pale, and some medications cause hair loss. It is very difficult for women to endure these changes. You can reassure the patient that “I always like you,” but the woman will not be reassured by an untruthful stock phrase.
Changes in appearance are upsetting and frightening. One can hope that after completion of therapy everything will improve - this indeed is the case. Or you can, as in the “Fashionable Sentence,” change here and now: buy new clothes, put on makeup, cover up your hair loss with a bright scarf or hat. It is ideal to visit a stylist, it immediately changes your mood and increases your self-esteem.
Humility
Cancers are generally patient and loving. They forgive their partners many mistakes for which another sign would have broken up or even killed them long ago: rude jokes, deception, betrayal.
Not only that, they also try to verbally justify their partner: “That’s just his character,” “She just wasn’t taught.” And for many family problems they even blame themselves (even groundlessly).
But, of course, mistakes are not made just like that. Your partner’s shoals accumulate like a snowball...
Cooling
Cancer stops asking and begins to rely on himself for everything. After quarrels, he does not run to make peace first. And if the partner makes peace, Cancer thinks for a long time whether to forgive or not.
In the evenings, there may be silence in the shared apartment, since the representative of this sign avoids conversations, and may remain silent when asked “What happened.” He is in no hurry to hug.
However, the partner can still change everything if he can find out the reasons for Cancer’s sadness, and then correct his mistakes.
Guilt
The phenomenon of guilt is that it pops up wherever possible. In a situation where one of your loved ones gets cancer, a feeling of guilt is sure to run its course through each family member.
For the patient - for becoming a burden to loved ones (even if this is not the case), which makes their relatives worry (by the way, this is one of the most notorious reasons why patients do not want to tell their diagnosis to family members).
For relatives - for allowing their loved one to get sick (although, as we remember, there are no linear connections between these things), even for the fact that they are healthy, but the loved one is not.
If a loved one dies, the feeling of guilt becomes much worse:
“I didn’t do enough for him to get better.”
- I was a bad mother.
- How dare I continue to live when he died?
“His death is punishment for my sins.”
Sometimes, when a loved one is at the terminal stage of the disease, relatives begin to intensively drag him to doctors, take him to traditional healers, and subject the person to painful and useless procedures precisely so as not to feel guilty.
What to do with guilt?
Remember that it is irrational. No matter how much you do, it will always seem like it is not enough. If you catch it in yourself, don’t brush it off. Just acknowledge that it is there and remember that it is irrational.
I grieved for a long time, it seems like a year and a half or two. Immediately after my mother's death, I experienced denial and shock. It was difficult to fully comprehend that she was gone. It was very difficult. I cried a lot at night. I was tormented by a feeling of guilt.
I was angry with my mother.
After her death, I discovered a large amount of money in her bank account. At the same time, my mother washed by hand, although she could afford to buy a washing machine.
Mom really wanted to visit Paris. I wanted to go, but I didn’t go. Although financially she could afford it. I remember I once watched a French film. For some reason there were croissants at home. Mom loved both croissants and French films. I wondered if Mom had seen the movie. And then I realized that he came out after her death. This happened a few years later. I remembered this moment because that was the last time I cried, remembering my mother.
Now I understand that I myself needed support. Both psychological - the opportunity to talk about what is happening with my mother, with friends - and help in everyday matters. I could use some personal therapy too.
Was I aware of these needs then, not being a psychologist? No, I didn't even think about it. I also learned about the stages of grief much later. Maybe this knowledge would help me survive her death. I didn’t even think about self-support and self-care.
Sometimes I closed myself off. Many psychologists rightly consider student age to be adolescence. Emotions, maximalism, defensive reactions. I was not able to talk openly about my feelings, although perhaps it would have helped me.
Time passed as usual. The pain gradually subsided. 11 years after her death, I can talk about this calmly.
I want to give advice to those whose loved one is terminally ill.
At some point I realized that along with a person his memories go away. For example, as a child you did this and that, behaved in such and such a way. There are a lot of such messages in live communication. You will recognize yourself from this. When my mother died, I realized that I had no one to ask about these things.
With her went her look, her memories, not only about me, but also about her, about the small valuable details of her life that there was no one else to tell about. A part of my life, a part of me, is gone.
My advice is this: communicate more with the relative who is dying, ask him questions. This is more important than any inheritance, it is an inheritance that is part of you, your life, your family.
