For many people with cancer, hands-on caregiving may only be needed for brief periods of time, such as following surgery or following chemotherapy sessions. For others, the situation may require constant or almost-constant caregiving and assistance.

At the heart of developing a cancer caregiving action plan is learning how much caregiving your loved one needs, now and in the future. Also, it's important to understand that caregiving needs will change with the progress of, or recovery from, the disease. For people who experience successful treatment, recovery usually leads to growing strength. For others, time may bring a downward trend, and the individuals who are not able to recover will need additional assistance as time passes. For others, the cancer journey may involve periods of remission followed by recurrence.

Questions to consider in evaluating family caregiving needs:

• Can the individual take care of most daily functions of life on her own, such as bathing, using the toilet, eating, walking and dressing?

• Can the person with cancer manage his affairs, such as paying bills and taking medications when needed?

• Is the person with cancer able to see well? hear? move comfortably?

• How fatigued is your loved one? Is she able to consistently perform most of the functions of daily living without special assistance?

• If your loved one lives alone, would some forms of temporary assistance, such as occasional housecleaning service, help? Or if he or she lives with you, would these kinds of services ease demands on you?

Questions to consider in making a caregiving "plan of action":

• Think through the probable needs of your loved one
Separate short-term and one-time needs from ongoing needs
Think in terms of emotional needs, physical needs, and medical needs

• Of these needs, which ones can be managed by other people?

• Of these needs, which ones will you manage by yourself?

• Create a list of people who can help
Family members, Friends

• Determine which needs can best be managed by outside assistance, such as nursing care, respite care or adult day care.

Have a list of health care contact information. Make sure you know how to reach appropriate members of your loved one's health care team, 24 hours a day, seven days a week, for both routine matters and emergency assistance. Post this information near a phone, so that other caregivers have access to it if needed when you are not available.

Develop a list of helpers. When a diagnosis of cancer happens in a family, often many friends and family members will offer help. This offer may be general: "Let me know how I can help." Or, the offer may be specific: "I'd be glad to bring dinner over a few nights a week." All too often, many caregivers are reluctant to follow up on getting help. There are many reasons for this reaction, ranging from feelings of self-sufficiency to not wanting to be obliged to others. Whatever the reason, if you find yourself reluctant to accept assistance, it's appropriate to second-guess yourself a bit, rethink your view and consider what forms of assistance will be least distressing to you — and begin there, accepting assistance in areas most comfortable to you.

Once you've prepared a list of the kinds of assistance you may need, and have decided which tasks you will undertake, it's time to match family and friends to those tasks with which you need help.

Remember that for many people, cancer treatment is an ongoing process for months, even years. No single caregiver, no matter how energetic and devoted, should assume that he or she can meet all of those needs single-handedly. As you consider possible helpers, think not only about immediate needs, but also tasks that will repeat over and over throughout the course of the illness.

In general, people who offer to help are sincere, and they tend to respond most positively to specific requests, especially those that are not very disruptive to their own lives. Start with family members first in making your specific requests for help, as they probably feel a special bond with the cancer patient and will want to be included in the circle of those providing help. Next, consider friends and neighbors that you know reasonably well. For example, you might ask a good friend with a flexible schedule to occasionally take the person with cancer to medical appointments; you may ask a neighbor to prepare a meal for the family one night every two weeks.

If, like many families today, your immediate family members live far away, you will probably be more dependent on friends and your social network. Other good sources of assistance for some tasks and chores can be a faith-based organization such as your church or synagogue, as well as community organizations that provide volunteer services. If you need community assistance and are unsure where to begin, consult your hospital's oncology social work department for guidance.

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