(Topics with a front of them are actions you can take or symptoms you can look for.)
Unfortunately, something important is lost when people with cancer see fewer and fewer people. They lose the stimulation of thinking about other people's lives, they lose the ability to see their own problems in a larger perspective, and they lose the suggestions and help which others can give. They also forget that other people love and care about them.
It is important that you, as a caregiver, do what you can to prevent social isolation. You should invite people to visit, organize the visits so they are helpful to the person with cancer, and make the visit rewarding for the visitor so that he or she wants to come again. This home care plan will help you to do that.
Read the home care plan on Coping with Depression for guidance about when and how to get professional help for depression.
|Make a list of companions.|
As you make your list, consider the following types of people:
|Don't worry about how far away these people live, how busy they are, how long since you've talked to them, or even how well you know them.|
|Telephone calls are often easier to arrange than inviting someone to the home.|
|Helpers are often volunteers in community or church organizations,|
|Pets are another kind of companion that have been helpful and supportive for many sick people.|
Following is an exercise where you can list companions and note how to make visiting enjoyable for them. We recommend that you complete this list now and that you add to it throughout the illness. Then it will be ready to use whenever you need it.
|Thinking about the visit from the point of view of the other person will help you to make the visit more pleasant.|
Next to each person on your list, write what he or she would like or enjoy about being with the person with cancer. Ask yourself, "What would make a visit really nice for him or her?"
|The following are examples of how home caregivers have made visits enjoyable for their visitors.|
"Phil is a workaholic. That's all he thinks about. So when we get together, we ask him about work and he loves it."
"My wife loves to talk about personal things that happen to people. So does her friend Mary. When we get together with Mary, they both talk about the people they know. Mary has a great time and so does my wife."
"Joe's not a great talker, so I arrange for him to be doing something when we get together. Sometimes it's cutting up food for the meal; sometimes it's playing cards with Dad. But it gives him something to do when he's with Dad, and this makes him feel comfortable about not talking all the time."
"Nancy is into fancy cooking. She's a great cook and she really appreciates a meal that takes some effort. So, when Nancy visits, I fix something special to eat. It's a way of saying 'thanks for coming' that Nancy understands."
"Bill has a lot of problems of his own, so, when we visit him, my wife and I spend a lot of time listening to him talk about his problems. Sometimes we can help him, but mostly we help by listening. Bill likes an audience, and my wife and I don't mind listening-it makes us think our problems aren't really so bad."
"Judy is embarrassed if you thank her for coming. She likes to pretend that she was just passing by. So Andy and I play along. When I see her after church, I tell her how much her visits mean to Andy. Then I can tell she's pleased."
1. "People should volunteer to visit without being asked."
Response: If you feel this way, think back to people you knew who were sick and how difficult it sometimes was to find the time to visit. The fact that people don't volunteer doesn't mean that they don't care. Probably they would welcome the opportunity to visit-if they were asked.
2. "I'm afraid I'll be turned down if I invite people or if I ask to visit them."
Response: Think of yourself as asking for the person who is sick and not for yourself. This way you are not so personally involved. If you ask people to do something they enjoy doing, it is more likely that they will accept.
3. "Some people feel awkward talking to someone who is sick. They don't know what to say."
Response: Have something to do-for example, a card game or puzzle to work on. Then they can talk about what they are doing, or they can be comfortable not talking at all because they are paying attention to what they are doing.
4. "The person I am caring for says he doesn't want people to see him when he is sick." Response: Encourage talking to people on the phone. You may also suggest inviting people who are used to seeing sick people-for example, people who have been caring for someone who is sick. You can also arrange activities that the visitors enjoy so that the appearance of the person with cancer isn't as important.
5. "Some people are well meaning, but they boss us around or say things that are upsetting."
Response: Well-meaning people are not always helpful, so think carefully about when their visits are helpful and when they are not. Invite them when their helpfulness outweighs any problems they cause. If you and the person with cancer know what to expect and are prepared, you can steer the conversation in helpful directions during the visit.
6. "Some people stay too long and tire us out."
Response: Ask them beforehand to limit the time they stay. This takes the pressure off of everyone about when to end the visit.
What additional road blocks could get in the way of doing the things recommended in this home care plan? For example, will the person with cancer cooperate? Will other people help? How will you explain your needs to other people? Do you have the time and energy to carry out the plan?
You need to develop plans for getting around these road blocks. Use the four COPE ideas (creativity, optimism, planning, and expert information) in developing your plans. See the chapter on Solving Home Care Problems at the beginning of the book for a discussion of how to use the four COPE ideas in overcoming your obstacles.
Make up a list of people who can give companionship. Keep adding ideas for how to make visiting pleasant and rewarding for them. Try new people. Don't just stick with the easy ones.
Invite people to come to visit the person with cancer or go to visit them. If you are uncomfortable inviting other people, ask others to do the inviting for you. Use the telephone to visit and encourage others to call. Set deadlines to do this, or you may put it aside.
You will know if your plans for companionship are successful by the number of times-either in person or on the phone-that the person with cancer is meeting other people.
Don't be discouraged if you are not completely successful in the beginning. You will become better with practice. Start with people who are easier to visit or invite and gradually try people who are more challenging.
If you are having problems, ask other people to help you and to give you ideas. When you are under pressure, it may be more difficult to reach out to others. If so, ask others to help you.
You should repeat these problem-solving steps regularly throughout the illness to ensure that the person you are caring for has the companionship he or she wants and needs.
Jul 1, 2010 - Immunosuppressive treatment with cyclosporine A, rather than tacrolimus, with dose level monitoring two hours post-dosing or in patients age 50 or younger appears to have a significant association with the development of de novo cancer after liver transplantation, according to research published in the July issue of Liver Transplantation.