The first hundred days after hearing the diagnosis of "cancer" are a time of general existential crisis for the patient and his family. It is a mental, physical and spiritual "earthquake" - a difficult period of realizing that nothing will ever be the same again and an attempt to find one's way in a new reality. At this stage, persistent questions arise that are usually unanswered. The most common of them are: "Zand what is all this?”, “Why us”, “Where is God?”. The family, just like the patient, needs time to get used to the situation.

The so-called appear defense mechanisms. These are reactions and behaviors that help the family adapt to the difficult reality for some time. The most common form of disease is denial and denial - active denial of the extent of the threat: "it can't be that, it's just that the symptoms are similar." Such thinking and postponing bothersome emotional experiences provide some distance from the facts. Another reaction is to talk about everything except what the patient wants. This behavior is called communication blocking. Avoidance is similar to blocking, i.e. talking about little things, focusing on care activities, feeding, talking to staff and minimizing the importance of the situation. Defense mechanisms fulfill an important function - they give the patient and family the time necessary for all difficult facts to become aware of them. The environment should allow for their occurrence, although it should be noted that their effectiveness is short-lived. Long-lasting defense mechanisms are a signal that the family or its individual members are unable to function in accordance with the requirements of the new situation and need additional support.

HOW TO SUPPORT A CANCER PATIENT?

In order for family and caregivers to take good care of a chronically ill patient, they need to gain knowledge about cancer, its course, planned therapy, possible side effects of treatment and limitations in the patient's functioning and prognosis. The person most competent to provide this type of information is an oncologist and it is him who, with the patient's consent, should be talked to. It is good to properly prepare for a visit to the doctor, e.g. write down your questions on a piece of paper and go to the office with the patient. Other sources of knowledge are associations, oncological foundations, support groups, professional literature and reliable websites. With sufficient knowledge, you can offer specific help to the patient, taking into account his needs and your own capabilities. It is best to ask your loved one what help they expect from us. The subjective belief of caregivers about the patient's needs may be illusory and inaccurate. It is also important to remember that devoting yourself beyond your strength does not contribute to good long-term care. Just like promising impossible things to a sick person. It is worth including others to help - friends, extended family and volunteers. This supportive group maintains a greater distance so that they can provide common sense. On the other hand, it is important to control your visits. It is best for relatives to visit the patient one at a time or in two people. Any gifts should be tailored to the interests and current condition of the patient. Nursing a sick person is a privilege, but also a challenge. It is good to share your problems with the patient and ask for advice. This will make him feel needed and not like an object to be dealt with. Caregivers cannot forget about their own needs, they must have time to rest and unwind. Otherwise, they risk burning out quickly.

DIFFICULTIES IN PROVIDING CARE FOR CANCER PATIENTS

Various limitations appear when caring for a chronically ill patient. A common restriction imposed by the caregiver himself is not allowing himself to pursue his own plans and needs, because this would be a betrayal of the patient. Unfortunately, without allowing yourself for small pleasures, implementing plans, getting enough sleep or eating properly, it is not possible to take care of someone wholeheartedly for a long time. The most common excuse for caregivers is that they don't have time because they have to be with the patient all the time. Another limitation is the need for the caregiver to control everything, "because no one can do it like me." This leads to tensions and conflicts with other caregivers and the patient himself. It's worth being replaced and sharing control. Another issue is the lack of consent to one's own limitations. Even if healthy people do their best, they will still feel irritated, tired, helpless and depressed. They will always blame themselves for some reason. It is helpful to seek support from others. We don't have to shoulder the burden of care alone. Other limitations that may occur include difficulty in accepting the patient's changed appearance and developing symptoms of the disease. Sometimes it's hard to constantly reassure you about your feelings, encourage you and be close to you.

FAMILY EXPECTATIONS TOWARDS FRIENDS AND ACQUISITIONS

Friends and family acquaintances are called "second-line caregivers." Some of them will instinctively know what to do to help, others will need an "user manual" and detailed instructions. Without a chain of friendly people, loved ones are unable to care for a chronically ill person with care and love. Thanks to the help of second-line caregivers, they can take care of themselves, rest, catch their breath and meet their own needs. The patient's close caregivers should prepare to use the help of friends or relatives from the very beginning. They should know their own limitations and capabilities and move within them. It would be a good idea for your loved ones to write down a list of their own needs on a piece of paper and pass them on to friends and relatives. This way, second-line caregivers will have a chance to decide how they can help and when. Collaboration in the care of a chronically ill means an honest and open conversation about the participation of each person helping, accepting what they propose and cheerfully accepting their help. Establishing a real help plan (who, what and when) significantly reduces conflicts and restores a sense of security. A certain cost and consequence of such an arrangement may be less privacy for household members.

CANCER DIAGNOSIS: CHANGES IN FAMILY FUNCTIONING

Changes caused by chronic disease occur slowly on many levels of family life. They are most visible in the reorganization of home space. The family must introduce facilities for the patient and themselves, considering that they will have to take care of the patient for a long time. Advice from people with experience in this matter, such as rehabilitation specialists, may be helpful. During cancer, the functioning of the family as a system changes. The family begins to need help in dealing with official matters, reassurance, emotional, informational and material support, or implementing specialists' recommendations. Family members experience shock and disbelief. The illness of a family member may lead to its merging, but sometimes also to its disintegration. The hierarchy of goals and values is changing. There are changes in fulfilling the duties resulting from the roles performed by the patient and the family. Roles may change when a spouse is ill. This can be especially difficult for men. Chronic disease causes negative effects for the patient and the entire family, including limited free time, spending, shopping and social contacts. There may be a change in short- and long-term plans, lack of honest conversations about problems, avoidance of physical closeness, suppression of feelings or showing hostility. In addition to the negative changes, there are also positive sides to struggling with cancer together. These include: greater closeness, increased emotional bonds, honest conversations and mutual support. A change in the functioning of the family means not only the adoption of new roles and responsibilities, but also a change in relationships. If the patient was the support of the family, now the supporter becomes the supported one. This may create tensions and conflicts. When cancer disease continues, the family faces the challenge of rebuilding a common path of life, eliminating the difficulties of the disease by focusing on the present day, skillfully asking for and using the help of others, not thinking too far into the future and not creating catastrophic scenarios.

Source: https://www.zwrotnikraka.pl/rodzina-wobec-choroby-nowotworowej/