[John]

When my wife, Susan, was diagnosed with breast cancer we both went in to shock. I felt angry and scared, but I didn't think I should burden her with my feelings. It's taken a lot out of both of us but we've found out that it really does help to talk about it.

[Elena]

When the doctors told us that there was nothing more they could do for my husband's cancer, we knew that we needed to find information to help us move forward.

[Sandra]

Our group of friends has become like an extended family. So, when Jean needed help, we all pitched in. Since I'm an oncology nurse and live the closest to Jean, I was happy to step up to be the coordinator of our caregiving efforts. It's meant a lot to me to be able to help her so much.

[Mary]

After my husband was diagnosed with cancer and after his surgery, he wanted me with him all of the time. Over time, I stopped doing many of the things I enjoyed so much and began to feel more and more isolated.

[Mei Ling]

My husband had just been diagnosed with lymphoma. I have two young children, a full-time job, and I am providing care for my 82-year- old mother-in-law. I was stretched about as far as I could possibly go.
 
[Brian's Father]

The day Brian was supposed to start his chemotherapy, he told his mom and me that his nurse talked to him about sperm banking. He said he needed to do this before he started his chemotherapy. His mom and I were afraid that if we delayed his chemotherapy, it might affect his chance of being cured. His nurse suggested we all talk to the doctor before making any decision. We told Brian that we would support his decision, whatever it would be.

[Katie]

My son's doctor sat me down and said, "I want to be sure you understand this. There are many people here to help you. We want to help you. Just tell us what you need." I will always be grateful for what she told me, and the way she said it. It made me realize that I could turn to other people to help give my son the care he needed.

[Grace]

I kept telling myself that taking care of Joe was more important than going to a wedding. But, I love Sharon like a daughter. I just felt so sad about not being able to be there on her special day.

[Narrator]

Welcome to the session of the Cancer Survival Toolbox called Caring for the Caregiver. This session is different from the other programs in the Basic Skills Cancer Survival Toolbox because it focuses on caregivers; that is, persons who give rather than receive care. It is meant to help family members, friends, or anyone else who has the sometimes difficult task of caring for someone who has been diagnosed with cancer. You can listen to this program on its own or you can order a complete set of the Cancer Survival Toolbox tapes free of charge by calling 1-877-TOOLS-4-U (that is, 1-877-866-5748). You can also place your order on the Internet through the website. You will find specific ordering instructions in the reference booklet that comes with this tape.

[Narrator]

Throughout all of the sessions in the Toolbox, you will hear the term "cancer survivor" used instead of other terms, like "cancer patient" or "cancer victim." This is an important point, because we define a survivor in the following way: from the time of diagnosis and for the balance of life, a person diagnosed with cancer is a survivor. Survivors are people who may have been diagnosed last week or 20 years ago. It can be anyone with any history of cancer. Cancer survivors may be receiving treatment, may be considered cured or in remission, may be trying to control the disease or its side effects, or may be receiving end-of-life care. Another important point to remember is that you, as a caregiver, are also a survivor. Although you may not have had cancer yourself, you, too, are surviving the challenges, responsibilities, and life- changing effects of this disease and its treatment. We hope the program will help you understand how important it is to take care of yourself - to take care of your own needs. Linda, an oncology social worker, has an important perspective on the impact of cancer survivorship on caregivers.

[Linda]

It is easy to become overwhelmed while caring for someone. Have you ever felt like everyone simply expects you to know automatically what to do, how to do it, where to go, and what questions to ask? This is probably an entirely new experience for you. You, too, have to learn about and adjust to all the complications of a disease that is threatening the life or the health of the person in your care. Here's a passage from Ross Gray, a Toronto psychologist, that describes the frustration with his caregiving role - I share this with caregivers I work with. "I have run a gamut of feelings over and over. Anger at the impact of illness on our lives, anger at my loved one for needing so much from me, sadness at her pain and my helplessness to take it away, guilt that I am not there for her enough of the time, guilt about my own desires to escape. This is tough stuff. Anyone, who has to care for someone over the long-term, can hardly help getting worn down, even bone weary, from the emotional turmoil." 

[Narrator]

Maybe you have felt some of these same feelings - or all of them - at one time or another. The challenge is to learn how to balance the needs of the person you are caring for with your needs.

[Narrator]

In order to find this balance, you first need to identify both the limitations and the strengths that you bring to this situation. Limitations may include high medical bills and not enough money; juggling a job with the care of children and an ill person; or your own poor health. Strengths may be an extended family that can help with everyday tasks; a generous employer who allows flexibility in your job; or a strong faith that helps to sustain you.

[Narrator]

Once you identify these limitations and strengths, you can then develop a plan of action that best cares for and nurtures everyone involved, including yourself. We hope this program for caregivers will help you by strengthening the following basic skills: First, communicating - so that you can express your own needs and feelings, and be able to listen to the needs and feelings of others; Second, finding information - so that you can better understand the disease and treatment, and also find the resources and support you need to care for yourself along with others; Third, making decisions- so that the burdens of care can be shared, and you decrease the chances of feeling overwhelmed or burned out; Fourth, solving problems - so that you are able to adapt to the changes brought about by cancer, and realize that you may need to tap into help outside of the family unit; Fifth, negotiating- so that you can work toward reaching agreements that work best for everyone; and Sixth, standing up for your rights - being able to ask for those things that you need. Let's begin with the first skill, communicating, by listening to John.

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