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This multi-level text can be used to teach Environmental Health at either the undergraduate or graduate level. Its flexible content and level makes it easy for instructors teaching environmental health in a variety of departments: health education/promotion, environmental science, physical education, and health science.

Susannah L. Rose, MSSW, is a Clinical Social Worker at Memorial Sloan-Kettering Cancer Center in New York Richard T. Hara, PhD, is a Clinical Social Worker at Memorial Sloan-Kettering Cancer Center

Introduction

ix

Part 1. The Basics

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Questions 1-6 cover the background topics in cancer caregiving:

What is cancer? How is it treated?

How do I offer to help a person with cancer?

What does it mean to be a "caregiver"?

Part 2. Managing Medical Treatment and Care

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Questions 7-26 discuss the complex medical issues surrounding cancer treatment:

We have met so many people involved in my wife's care. Who are all these people, and what do they do?

Who is the best doctor to treat this cancer? How do I find that doctor?

Where can I find reliable information about cancer?

Part 3. Helping Your Loved One Cope

45

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Questions 27-39 explore the emotional and physical challenges you may encounter while caring for a loved one with cancer:

I feel as though our lives have been out of control since my partner was diagnosed with cancer. How can we regain control of our lives?

I have heard that "positive thinking" can help cure cancer. Does this mean I should discourage my wife from thinking negatively?

How do I help my loved one better manage the emotional "ups" and "downs"?

Part 4. Caring for Yourself

65

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Questions 40-48 describe specific techniques for coping with cancer:

Am I getting "burned out"? What are the signs, and how do you prevent care-giver burnout?

What are support groups, and how can they help me? If I decide to try out a group, how do I locate one right for me?

Despite the fact that my son was diagnosed with cancer almost two months ago, I constantly think about his cancer and feel down much of the time. What should I do? Would counseling help?

Part 5. Relationship and Family Issues

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Questions 49-69 provide tips on handling relationship and family issues that arise during cancer treatment:

How can I be "strong" and supportive with my spouse while continuing to cope with my own reactions to this diagnosis?

I feel that my husband and I are growing apart since his cancer diagnosis. Why is this happening?

The doctor told me some news about my mother's cancer; should I tell her? Wouldn't it be better not to tell her and avoid upsetting her?

How do we tell the children about the cancer?

Part 6. Home Care, Medical Equipment, Placement, and Other Practical Matters

127

(16)

Questions 70-75 provide practical tips on handling outpatient care issues:

What is home care? What can we expect from home care after surgery and during other treatments?

What is a skilled nursing facility? How do you get in?

The doctors want my husband to get radiation therapy for the next six weeks, five days a week. I don't drive, and I'm afraid my husband won't feel well enough after his treatments to drive himself. How is he going to get back and forth from his treatments?

Part 7. Insurance Issues

143

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Questions 76-82 discuss matters related to health insurance and financial aspects of cancer care:

How can we protect our family financially while being faced with expensive treatments for cancer?

What if the patient does not qualify for Medicaid?

Prescription drug coverage is getting so expensive, even though we have insurance. Is there anything I can do to reduce this expense?

Part 8. Work Concerns

153

(10)

Questions 83-88 explore the employment issues and disability that can face people with cancer:

What is the difference between Social Security Disability (SSD), Supplemental Security Income (SSI), Social Security (SS), and public assistance (welfare)? How can a patient apply?

How should patients negotiate for sick leave or disability leave from work? Also, how do I negotiate for time off from work to be with my family member for medical appointments and to help her at home?

Will my partner be able to continue working during radiation therapy and chemotherapy?

Part 9. Emotional Reactions & Practical Concerns About Death and Dying

163

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Questions 89-99 describe reactions that a patient or caregiver might have when facing the dangers of cancer:

Is thinking about death bad luck? Although he doesn't talk much about it, I know my husband has been thinking about death and dying since the doctors first suspected he might have cancer. How much is normal?

The doctors say that there is nothing more they can do to treat my wife's cancer. What do I do now? Just give up?

Is making "quality of life" the goal going to shorten my husband's life?

Appendix The Appendix contains a list of Web sites, organizations, and literature to help cancer patients and their caregivers find additional resources on general and specific topics related to caregiving.

183

(28)

Glossary

211

(6)

Index

217

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