On the last track we discussed managing cancer in the workplace. Four guidelines for managing cancer in the workplace are don’t participate in denial, don’t reduce responsibilities without asking, flexible scheduling, and trouble signs and two steps to effective confrontation.
On this track we will discuss the caregiver’s guide to well being. Three interventions can be implemented with the caregiver of a cancer patient in order to increase the likelihood of that person’s well being. They are seeking support, understanding and compromise, and handling unwanted advice.
3 Interventions for the Caregiver's Well Being
Intervention #1 - Seeking Support
First, let’s discuss seeking support. In retrospect, your client may find the role of the caregiver to be rewarding. After her husband passed away from rectal cancer, Naomi stated, "I prayed and asked ‘Why.’ That’s when I found that two positive aspects of Ted’s cancer are the friends I’ve made and the friendships I’ve learned to appreciate and treasure. I’d never believed this could come out of such a horrible experience." Clients like Naomi may benefit from a suggestion to seek out friends who can and will support her in taking care of herself.
Using the eleven common reactions we discussed on the first three tracks of this course, I explained to Naomi that some friends she may not be in constant contact with may be hesitant to call her. Therefore, Naomi reached out to her friends while she was coping with Ted’s illness. Naomi stated, "One of the most important benefits of seeking support is having people to help you discover and share the important aspects of your life with."
Think of your Naomi. Does you’re your client or the caregiver your client is concerned about have friends who are there for them? If not, might you suggest a support group? I, like you, have found that caregivers can benefit from having a safe, nonjudgmental place such as a support group to discuss concerns.
Robert, age 52, was providing care for his 64 year old mother who had skin cancer. Robert found that he did not need to talk about himself. Robert stated, "Instead, I can listen to the ways others deal with their marriages, their children, and the cancer. When I hear another spouse talk about a marital problem, I’m more willing to listen than if my wife brought up the same issue. I can hear the problems discussed in the group without feeling like the comments are directed at me."
Intervention #2 - Understand and Compromise
Next, let’s discuss ways clients can understand and compromise. In the patient-caregiver relationship, understanding and compromising might boil down to differences in coping styles.
For example, a few weeks after he finished radiation, Max, age 34, withdrew emotionally from his wife Jessica. Jennifer stated, "Max isn’t a talker. He’s a pilot, so everything is mechanical, even emotional problems." Max responded, "I just need time to figure out my problems in my head before I talk about them with anyone else."
Clearly, Max’s coping style was different than his wife’s, but Max still had needs to be met. I stated to Jennifer, "Call a friend or family member when Max withdraws. Until he is ready to talk, seek out friends who listen well and acknowledge your feelings." Jessica stated, "It’s not hard to take what he does say personally, even though I know he is sick. Sometimes every word and every look seems like a direct attack." How might you have responded to Jessica?
I stated, "Sometimes you might have to just ask Max to provide you with what you need." Jessica found that some of the following statements led Max to pay more attention to her needs. Here are Jessica’s statements. "Sometimes I need you to tell me how I’m doing. I need feedback. I need to know if you like how I’m fixing your meals or making up the bedroom." And "I sometimes have feelings that I’m not doing enough, that I’m not doing things the right way, or that I’m doing all this work and you don’t even notice."
Intervention #3 - Handling Unwanted Advice
In addition to seeking support and ways clients can understand and compromise, a third method for caregiver well-being is learning ways of handling unwanted advice. How does your client handle unsolicited advice? Perhaps you might encourage your client to acknowledge the desire to help and use what advice he or she can. Some effective responses to unwanted advice might include, ‘I’m grateful for your support. Let me think about that.’ ‘I’m picking up what you’re putting down, but I’m not sure if it will work for me.’ or, ‘Let’s discuss this with the patient. He can tell us the best way we can help him.’
Dr. Lamar McGinnis encourages clients to ‘discount any information that is based on hearsay or untruths.’ As you probably know, relatives may try to help resolve conflicts without knowing the whole story. These "would-be" helpers may be basing advice on unrelated experiences. Would you agree that the people who offer unsolicited advice may be those who feel out of control, helpless, or anxious? The only way they can regain control is to offer opinions. Perhaps you might suggest that your client acknowledge the suggestion by merely saying "thank you" and cut the conversation short in order to help the person maintain his or her dignity.
On this track we discussed three interventions for caregiver’s guide to well being. They are seeking support, understanding and compromise, and handling unwanted advice.
On the next track we will discuss mastering the dynamics of anger. Five techniques for mastering the dynamics of anger are use visualization, talk to yourself and translate the meaning, be empathetic, not defensive, do not allow abuse and using anger to fuel energy in a positive direction.
Peer-Reviewed Journal Article References:
DuBenske, L. L., Gustafson, D. H., Namkoong, K., Hawkins, R. P., Atwood, A. K., Brown, R. L., Chih, M.-Y., McTavish, F., Carmack, C. L., Buss, M. K., Govindan, R., & Cleary, J. F. (2014). CHESS improves cancer caregivers’ burden and mood: Results of an eHealth RCT. Health Psychology, 33(10), 1261–1272.
Gudenkauf, L. M., Antoni, M. H., Stagl, J. M., Lechner, S. C., Jutagir, D. R., Bouchard, L. C., Blomberg, B. B., Glück, S., Derhagopian, R. P., Giron, G. L., Avisar, E., Torres-Salichs, M. A., & Carver, C. S. (2015). Brief cognitive–behavioral and relaxation training interventions for breast cancer: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 83(4), 677–688.
Kim, Y., Shaffer, K. M., Carver, C. S., & Cannady, R. S. (2014). Prevalence and predictors of depressive symptoms among cancer caregivers 5 years after the relative’s cancer diagnosis. Journal of Consulting and Clinical Psychology, 82(1), 1–8.
Shaffer, K. M., Kim, Y., Carver, C. S., & Cannady, R. S. (2017). Effects of caregiving status and changes in depressive symptoms on development of physical morbidity among long-term cancer caregivers. Health Psychology, 36(8), 770–778.
Online Continuing Education QUESTION 9
What are three interventions for caregiver’s guide to well being?
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