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Derry News/Eagle Tribune LET'S TALK - ABOUT THE CAREGIVER DERRY – A cancer diagnosis affects not only the patient, but everyone who loves that person. “It takes several months for the entire family to get over the shock of the diagnosis,” said Susan D. Block, MD, the featured speaker at the “Let's Talk” event at Promises to Keep last Wednesday evening in Derry . Block is the chief of the psychosocial oncology and palliative care division at the Dana-Farber Cancer Institute, as well as co-director of the Harvard Medical School Center for Palliative Care. “Let's Talk” is a series of educational programs on cancer care hosted by New Hampshire Oncology-Hematology, PA, in affiliation with the Dana-Farber Cancer Institute in Boston. Last Wednesday's presentation was also hosted by Parkland Medical Center . Barbara Umansky, an oncology social worker at Parkland , joined the speakers' panel for the second half of the evening. The event was well attended by both professional caregivers and community members who wanted to learn more about the family dynamics of caring for a loved one with cancer. Each event in the series is broken into two sessions – one for professionals, such as chaplains, nurses and social workers, and the second half a panel for members of the community. Over 150 attended the panel session, while 95 professionals attended the first half of Wednesday's event. Block called a cancer diagnosis “a recipe for terror” for family members. “It is not always as neat as what Elizabeth Kubler-Ross outlined in her stages of grief,” she said. “For some families, it's like climbing Mount Everest .” Kubler-Ross is known for her books on dying. Block said that it is important to include the family in a patient's caregiving. “A family member knows the patient better than the providers,” she said. “Often the family is in denial, but this is a desperate defense. Research tells us that denial is a psychological defense and usually means the caregiver is depressed.” She said it is important for medical personnel to recognize the caregiver, tell that person that they are doing a good job, and ask how they are feeling. Block emphasized the family needs to work as a team. “There is no one lone ranger,” she said. Dr. Peter Crow, an oncologist with New Hampshire Oncology-Hematology, gave his “inside the white coat” perspective. “When I have to give a patient a diagnosis of cancer, the more family members present, the better,” he said. “It's important to have more than one set of ears hearing the information.” Crow said another point for healthcare professionals is not to “sugar coat” the information. “You cannot shield the patient,” he said. “Some people will come up to me and say things like, ‘don't tell Dad,' but the patients already know better than anyone. “On the other hand, some patients don't want family members to know too much about their disease,” he continued. “I try to discourage this.” The panel was moderated by Mark Bevis, news director at New Hampshire Public Radio. The audience wrote questions that Bevis grouped into categories for discussion. Questions arose around medication and anxiety level, intimacy and hospice care. “Awareness of death is tied with terror,” said Block. “Some patients will refuse drugs such as morphine because they think, ‘well, I must be dying.'” Block said working with the family is helpful in lessening the anxiety. “There are medications that can work with pain medications that will ease fear and anxiety,” she said. Some audience members said cancer patients are afraid of entering hospice care because they think that's the beginning of the end. Crow pointed out that hospice is not “ending care, but redirecting care.” Janet Stocker, an adult nurse practitioner who recently joined New Hampshire Oncology-Hematology, spoke to the audience about intimacy issues. “This is a topic not often addressed,” she said. “It can be little things that make the couple happy.” She told a story of a woman whose husband took her to the mall to look at Christmas decorations. “As they were going up to the escalator, the husband heard a flute being played with one of his wife's favorite songs,” she said. “When they got off the escalator, he took her in his arms and started dancing.” Stocker reminded the audience to bring up the subject with their loved one. Umansky related her own experiences of being a caretaker when her father was diagnosed with cancer five years ago. “Cancer creates a crisis in the family,” she said. She said what helped her was taking out old photo albums and, since she was the youngest child in her family, hearing the stories told by other family members of the same events. She also suggested taking a “vacation day” from cancer once in a while. Block closed the evening by telling the story of one of her patients who had been a teacher all of her life. “When people have cancer, the hardest thing is that they think they've lost themselves,” she said. “It's not so much the impending death that bothers them, but the thought that the person has nothing left to offer.” Block told the teacher that she could teach some of the doctors at Dana-Farber about what it's like to go through a terminal illness. “The woman went home and told her husband that she had one final teaching assignment,” Block said. Donna Nichols of Londonderry said this was the second “Let's Talk” event she and her friend Connie Price have attended. “I think the open communication is wonderful,” she said. “Both times I have left with new information and a sense that the panel cares about what they might do better to help patients and families cope with cancer.” The next “Let's Talk” event will be “The Financial Burden of Cancer Care,” set for May 2 at the Elliot Hospital in Manchester . The programs are free. Visit www.nhoh.com for more information and to register. |
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