Transcript Effects of Cancer on the Family March 25,11

Presented by Lynn Barwick, LCSW
Presented by Xochitl Gaxiola, MSW in Spanish
Stress in patients and families well documented
Recognized psychosocial dimensions of cancer
Desire to improve psychosocial care
National Comprehensive Cancer Network:
Develop standards of care in 2008
Reduce stigma of psychological problems
Recommended use of term “distress”
(National Comprehensive Cancer Network. Distress Management
Guidelines, 2008)
“You have Cancer”
Disbelief, shock and panic
Anger and hostility
Fears based on risk of mortality
Feeling out of control and vulnerable
Losses
Learning language of cancer
Treatment decisions
(Social Work in Oncology, 2001)
 Physical side effects
 Body image changes
 Changes in roles
 Disruption of work, home, family
 Increased dependence
 Loss of dreams
 Emotional
 Insurance and Finances
Type of cancer, stage, prognosis
Degree of disability
Intensity of treatment
Age and stage in life cycle
Past experience with cancer
Current life circumstances
Degree of social support
Coping skills
(Social Work in Oncology, 2001)
Struggle to comprehend – Why me?
Continuum from denial to acceptance
Vacillation between hope and despair
Sense of personal failure
Bad things do happen to good people
Making sense of life and death
Creating a new normal
Changing priorities
Greater sensitivity towards others
Increased closeness in relationships
Awareness of life’s gifts
Spiritual quest
A negative, life-altering experience
(McMillen, 1999)
Children need to know:
 Name of disease
 Part of body being treated
 They did not cause the cancer
 They will be loved and cared for
 It is unlikely that other parent will get cancer
 It is unlikely that they will get cancer
 Routines will be maintained as much as possible
Adolescents
 Interruption or delay of individuation from parents
 May need to take on more responsibilities
 Need relief from responsibilities
 Need to be thanked
 Need time to be with peers and maintain activities
 Reassurance that it is okay to have fun
As a Family we can Cope
(When a Parent has Cancer, Wendy Harpham, MD, 1997)
--Caregiver Needs-Physical assistance
Support Groups
Cancer education
Respite care
Financial assistance
Counseling

Identify patients with psychosocial needs

Facilitate communication

Collaboration with health care team

Maintain cultural sensitivity

Help patients and families feel more in control
(Social Work in Oncology, 2001)
Psychosocial Needs & Services
 Information about illness, treatments, services available
 Assistance coping with emotions regarding illness
 Help in managing illness related symptoms
 Counseling for changing behavior or mood issues
 Educational material and resources
 Help in managing disruptions in work, school, family
 Financial assistance with community resources
(Cancer Care for the Whole Patient , 2008)
INTERVENTIONS FOR
DEPRESSION AND ANXIETY
 Referral to social worker for assessment
 Mood Disorders or Suicidality
 Decision-making capacity
 Safety concerns
 Counseling by social worker
 COPE D Study – PHQ-9
 Short term counseling to help with issues
 Referral to psychiatrist or therapist
 Psychotropic medications
 Support groups
Compassion Fatigue
 We work in a high-loss, high-stress environment
 Recognizing signs
fatigue, headaches, sleep difficulties, GI
disturbances, irritability
 Grieving losses
 Renewing oneself
Finding balance
Cancer Caregiving Rounds
Learning to maintain personal boundaries
References
Harpham, Wendy (1997). When a parent has cancer: A guide
to caring for your children. New York: Harper Collins.
Institute of Medicine (IOM). 2008. Cancer care for the whole
patient: Meeting psychosocial health needs. Nancy Adler
and Ann E.K. Page, eds. Washington, DC: The National
Academies Press.
Lauria, Marie, et al. (2001). Social work in oncology:
Supporting survivors, families, and caregivers. Georgia:
American Cancer Society.
McMillen, J.C. (1999). Better for it: How people benefit from
adversity. Social Work, 44(5), 455-468).
National Comprehensive Cancer Network (1999). Practice
guidelines for the management of psychosocial distress.
Oncology, 13(5A), 113-147.
Look for Peaceful environments
Any questions, comments or
discussion?