FAMILY GAMES CAN LIGHTEN THINGS UP

Sometimes it's hard for families to cope because their child is feeling the effects of treatment or the illness. Families stop playing and having fun together. Play is very important in a child's life. Having fun is an important bonding tool, especially for siblings. But how do you help your sick child to have fun with siblings who may have higher energy levels?

You can adapt some common card games to increase the fun quotient. You can use a regular deck of cards, minus the jokers. In Go Fish, the players try to match two of a kind by asking other players for cards they need to complete their pairs. The dealer deals seven cards to each player and places the rest of the deck on the table. The player to the dealer's left starts. If a player asks for a card from another player, but doesn't get it, he or she must pick from the pile. As soon as a player has all four of a kind, he or she puts it down. But what if you add a challenge to the game? Why not require the player to do a fish impression before he or she asks for a particular cards? Why not require that a player "swim" around the group before setting down those four of a kind? Your sick child can participate from his or her bed, by pretending to swim.

Crazy Eights is another game that can be adapted to create more physical fun for the group. The object of the game is to get rid of all your cards first, by playing off of the other players' cards. The dealer deals five cards to each player (seven if only two people are playing) and the rest go into a pile. The dealer turns up the first card on the pile and the player to his or her left must play a card of the same number or suit. If the two of hearts is the first card, the player may play a two or a heart. If a player has an eight, he or she may call for a new suit. In your version, you can require that the player who plays the eight has to do a silly dance around the group to announce the new suit. If it's your child's turn, but he or she doesn't have the energy to get out of bed, your child can pick someone to do the dance or your child can sit in bed and do a modified version, even using a puppet to make it sillier.

Why do these kinds of activities with a child in cancer care? Very often, the first thing to disappear from the home when a child is seriously ill is the laughter. This is often devastating to siblings in the family, but it also affects the sick child. When parents let go of the stresses and worries of caring for their child, and they engage in fun activities like playing children's card games in a silly way, they encourage the family to laugh again. Laughter is a very important bonding tool. Being able to have fun together means you're still a family, in spite of the cancer. Card games don't really take very long to play, but if you can enjoy them as a group, it sends the message that you can work together while your child is sick. And having the chance to move, even if it's a goofy dance, lets go of some of the tension that builds up in the body, especially if the family is sitting for long periods of time in a hospital room.

For more ideas on family fun, visit my website:
https://sites.google.com/site/thepracticalcaregiversickkids/

WHY ENGAGE SERIOUSLY SICK KIDS WITH ACTIVITIES?

One of the toughest things for parents, when a child is seriously sick, is to focus on engaging the child in activities. Why? We tend to think that children can't and shouldn't do anything when ill. They should conserve their energy and just focus on getting better.

But what happens to children who are seriously ill, especially if it's cancer and the outcome is uncertain? Do we send them the wrong message by putting learning and fun aside?

What do children need to hear when they have a serious illness? That there is nothing we can do to help them? That they are destined to lie in bed and watch TV all day long or play video games? The trouble with that is they aren't socializing in a meaningful way.

Children who are ill over a long period of time can sometimes lose their emotional connections to family members. Their illness and medical treatments can create a serious sense of isolation and abandonment for them. This can result in attachment disorder.

Even children who are confined to bed can still connect with family through games, play, and projects. You can still play "Simon Says" with your child, even if you just limit movement to the fingers, hands, and face. Your child can still play on his or her bed. Even sick children can create projects, books, and drawings. But to do that, they need parents that are willing to make the effort.

Sometimes parents get so bogged down by what cancer does to their child, they stop seeing what their child can do for himself or herself. If all you can think about is the cancer, you're not living in the moment. You're not empowering your child to play, to learn, and to grow.

If your child's cancer care has him or her stuck in bed, make good things happen. Help your child stay connected emotionally and physically to family and friends. Don't let cancer determine the state of your child's emotional health. Be proactive. Give your child a chance to use this time to forget about what cancer has done and to just have some good, old-fashioned fun.

For more tips on helping your child during cancer, visit:
The Practical Caregiver Guides

WHY DVD PLAYERS ARE GREAT GIFTS FOR CANCER PATIENTS

DVD players are fairly inexpensive, and your loved one can also use one to watch movies. Many computers have built-in drives that will play these. Why not utilize them to help cancer patients feel connected to the "real world"?

What can you do with a DVD player when you want to cheer up a cancer patient who's physically challenged or limited by treatment side effects? You can:

Make video greetings
Record stories and memories
Share a book
Perform a song, dance, or skit
Record a recital or sports event
Recite poems
Show a favorite pet trick
Take a tour

Many times, family and friends want to give their loved ones something meaningful. A gift of the heart reaches out, beyond the miles. DVD's can be inexpensively made and mailed. If you climb a mountain, why not record a message at the top for your loved one? If you go fishing, why not capture the exciting thrill of reeling in a big one? If you take a drive to see the Christmas lights, why not record the magic of the moment? When you point your camera at what you are seeing, you are sharing the experience with someone who may not have the energy and stamina to get out and about. You're saying that life is still happening and you want your loved one to be a part of it. It gives you something to talk about, to laugh about, to enjoy together.

What's the best part about a really good DVD? Your loved one can share it with other people. Whether it's a grandchild performing a dance or a friend telling a funny story, the moment lives on through the DVD.

Why not be creative? Do you have a relative who does a great impression of master chef Julia Child? Put him or her in an apron and do a silly cooking demonstration. Does a relative have some comical advice on how to handle "difficult" doctors? Or is there an artist in the family? Why not share the latest painting or sculpture? Do you have a singer who can really hit those notes and belt out a tune? Is there a stand-up comic in the family who has a funny routine? Got a pet that has a silly trick or habit?Record the moments to share. It's not about the cancer. Family life is the glue that holds us together through the tough times.

Maybe you had a big snowstorm and got busy with building a snowman with the kids. Did you create a masterpiece? Or a snow village with a crowd of snowmen and snowwomen? Are you heading to a winter carnival, complete with ice carving competitions? Or maybe you're off on a cruise, to the land of tropical trees, gorgeous beaches, and aquamarine waters. Do a little travelogue for your loved one. Share your experiences. It sends the message that you do really care, that you are really thinking of him or her, and that you want to stay connected, even during cancer treatment.

You might be surprised at how easy it is for cancer patients to fall out of contact with family and friends. It's easy to feel forgotten when the phone doesn't ring as often and there's nothing in your inbox or mailbox. Cancer treatment can be very isolating for your loved one. Making the effort to stay connected is important, and caregivers can really help by encouraging the extended circle of family and friends to remain in touch.

KEEPING CHILDREN ENGAGED DURING CANCER TREATMENT

It's hard for parents to see their child in a bed,overwhelmed by cancer and its treatment. So many times, families spend their days at the hospital, watching helplessly as their loved ones get radiation, chemotherapy, and even surgery.

Usually, the disruption to family life puts a tremendous strain on everyone. The child with cancer suffers from the side effects of the treatment and from the cancer itself. The parents suffer the emotional anguish and often physical burden of having a child seriously ill. And the siblings, too, find that childhood disappears in the midst of such a grave situation.

Sometimes the hardest thing to do during this time is to stick to family routines and traditions. If you're familiar with hospital life, you know there's rarely a schedule that goes right.

But parents can do some things to keep the family focused, even when a child is hospitalized. Whenever possible, stick to normal routines. If your child regularly naps in the afternoon, make that a quiet time. Tell relatives and friends that is not a good time to visit. Stick to normal bedtimes as much as you can. Half an hour or so before your child normally hits the sack, turn off the TV. Remind your child to brush his or her teeth. Read some stories together. Help your child to settle down for the night.

To many parents, it may sound strange to have your child follow routines when seriously ill, but the truth is it can provide a sense of security during a stressful time. Structure and routine tell your child everything is "normal" and that you're still in charge of their lives in a positive way.

It's also good for you. Sitting in a hospital, day after day, is emotionally and physically exhausting. When you keep family routines going, it allows you to have some control over your life. You're making parental decisions for your child. The doctors and nurses will make the medical ones. As much as it is difficult for you to watch your child go through cancer treatment and deal with the side effects, you need some structure and routine as well.

Engaging your child in play is another way that parents can help their children. Play allows a child to release stress  and anxiety that builds up during the day. Whether you challenge your child to a game of cards or to draw a special picture together, you are showing your child you still believe in him or her.

Sometimes the hardest part of cancer treatment is to leave it behind for a little while and just have some fun. Laughter can lighten the heart and opportunities to learn and have fun can help a cancer patient feel more normal again. They feed the soul. As a parent, you still have power to help your child in very positive ways. Use it wisely and appreciate it for what it is.

For ideas, tips, and activities for children with cancer, visit my websites:

THE PRACTICAL CAREGIVER'S GUIDE FOR SICK KIDS STUCK IN BED
https://sites.google.com/site/thepracticalcaregiversickkids/

BARKLEY AND RUFFUS MCDILLY'S GUIDE -- HELPING SIBLINGS COPE WITH A CHILD'S SERIOUS ILLNESS
https://sites.google.com/site/barkleyandruffusmcdillysguide/

CHRISTMAS GIFTS FOR KIDS WITH CANCER

It's hard to know what to get a child who has cancer for Christmas. Often we forget that there are opportunities we can utilize to help the child stay involved with life.

Depending on the age of the child and his or her abilities to engage in play while under medical treatment, family and friends can actually choose from a wide range of toys and games.

Many children hospitalized will probably tell you they are often bored. It's hard to be stuck in a bed for hours on end. If you don't have the energy to go to the play room, or if you are isolated from other children because your immune system is down, you should still have the chance to play.

Travel-sized games are great for kids who are stuck in bed. They can be played on a tray table or a foam board that you buy at the local office supply store. When a meal comes, you just lift the light-weight board off and set it aside. These are also great for doing puzzles.

Never underestimate the power of a kit for a child cooped up in a hospital bed or at home. There are many award-winners that have been tested and approved by experts. If your child is a doll lover, you can find a cardboard doll house kit that your child can decorate. There are kits for making little purses, gardens, jewelry, memory tiles, and so many other things.

But sometimes even just simple gifts, like a deck of cards, can offer a child hours of fun. You can get fancy and find colorful illustrated versions of Old Maid, Go Fish, and even Uno. Cards don't take up a lot of storage space at the hospital. They tuck into a drawer.

And there's always Rubik's Cube, the ever-challenging  3-D puzzle.

But sometimes there are simple little gifts that can mean a lot. Snow globes can be a wonderful bedside Christmas decoration when there isn't room for a tree. It's a magical wonderland of hope and promise.

Even when held down by illness, children are still children. If their bodies can't provide them with adventures, bring the adventure to them. Give them the opportunity to exercise their minds.

For more suggestions and tips, visit my free guide, The Practical Caregiver's Guide for Sick Kids Stuck in Bed:
https://sites.google.com/site/thepracticalcaregiversickkids/

CREATE A CANCER FAMILY WEBSITE

What can you do with a cancer family website, to help support your loved one through active cancer treatment and beyond?

1. Keep family and friends in your loved one's circle updated on the current situation. When you create a blog page, you or your loved one has the opportunity to communicate important information to those in the circle.

2. Give your loved one a chance to create a list of wishes, hopes, dreams, goals, or anything else that he or she needs. By sharing this with the circle, your loved one can find support and encouragement, and possibly even help.

3. Notify the people in your loved one's circle of events and fundraisers that are undertaken on behalf of your loved one, or even family trips to special places.

4. Create a "contact" list of those people in the circle, with addresses, phone numbers, and email information. This can help when people want to join forces to help your family.

5. Share photos of your loved one, as well as anything else that matters to him or her. Maybe your loved one has favorite memories to be shared, or a special event. By creating a web page for this, the circle has the chance to be a part of your loved one's life.

6. If your love one is undergoing a special treatment, such as a bone marrow transplant, the website can help your family and friends stayed in touch, even if you need to travel out of state for the care.

7. Create a family calendar of events that is accessible to the circle. This is wonderful when you need help with transportation, child care for the family when your loved one is having treatment, or even to notify your circle of social gatherings.

8. Have a "To Do" list of needs that your family is having trouble meeting during cancer treatment. If you have children, you may want family and friends to help them stay active while you are managing cancer treatments. Siblings often have a difficult time, and having the chance to get out with family and friends can relieve the stress and fill the gap. Parents of children with cancer and parents who are the cancer patients often don't have the time or the energy to provide the kind of attention and activities children need. Let friends and family help by letting them know this is needed.


Children undergoing cancer treatment are often out of school for extended periods of time. A cancer family website could help your child remain connected to his or her social circle during absences. It's really hard for children to be separated from their friends, but sometimes it's necessary. Finding ways to help them through such times is very important for emotional support and for social development. You might create a list of books your loved one has read.

Whatever you do when you put together a cancer family website, remember that privacy can be a serious issue. You can restrict access to the family website, and I recommend doing this. You can also make the calendar accessible only to those on your list.

If you would like more ideas on family care-giving during cancer treatment, visit:
The Practical Caregiver Guides

IS THERE TOO MUCH PRESSURE ON CANCER PATIENTS?

In a perfect world, all cancer patients would be cured of this insidious disease and they wouldn't have the side effects that come with surgery, radiation, and chemotherapy. But alas, cancer is what it is.

Is there too much pressure on cancer patients to cure themselves? In our effort to believe the impossible is possible, do we push cancer patients too much, to the point where they feel they have failed when cancer spins out of control? How can we help them to engage in their battle against cancer in a more realistic and honest way?

We know that attitude is a huge part of keeping a patient moving towards cure. If you believe that there's a good chance you can be cured, you will undergo treatment and follow-up care more regularly, and that will keep you in better shape to get past the obstacles that stand in the way. But there is more to cure than just attitude. And that's where setting realistic goals is important.

Do we ask an average athlete to compete in the Olympics? Or an untrained singer to sing a difficult aria? Or someone who is new to chess to play a chess master? The scales aren't tipped in favor of those who don't have what it takes. Most of us are not super-human and we don't have super powers.

Perhaps we should be helping cancer patients to develop their strength in living life while fighting cancer. Cure does not come overnight, but over time, and in stages. If cancer is a mountain that needs climbing, cancer patients need the stamina, the skills, and the support to make it. The truth is that we often don't always know everything that is going on in the body of a cancer patient. Cancer can hide out for some time before it is discovered.  If patients spend all their time and energy in seeking cure, don't they miss the living along the way?

Like students who are pushed to be over-achievers, cancer patients can feel like failures, feeling anxiety over cancer treatments that may not succeed. Instead of living their lives and finding the joy in the moment, they worry that the cancer will win and they will lose. They put their "all" into the battle against a powerful foe, and in doing so, miss out of what really matters.

The truth is we all will die at some point in our lives. There is never enough time to do all of the things we want to do in life. But if cancer patients spend all their time wrapped up in the idea that they must fight and beat cancer, cancer controls their lives. It permeates every facet of their lives, every waking hour.

Not everyone was made to climb Mt. Everest. And many of us wouldn't want to be alone at the frigid summit. The average person wants to love and be loved, to laugh and share, to enjoy what is most precious in life. If you are able to do that while facing cancer, you truly are a winner.

JINGLE ALL THE WAY

What do you give a cancer patient for Christmas that can improve self-esteem and provide a little confidence? For those patients with significant hair loss due to chemotherapy, a hat can be a fun gift.


Got a lover of sports teams? Why not get him or her a team logo cap? The wonderful thing about sports caps is they can be collected by non-cancer patients, too. That makes it even more appealing, doesn't it? How many sports fans have a cap collection? It's the kind of thing that can almost be addictive. In this day and age of Internet shopping, you can get apparel for just about any team that exists, whether it's a local team or even a foreign one. If you throw in a banner or a mug, the cap suddenly isn't just about cancer and covering up a bald head. It becomes a matter of supporting a beloved team. Kids who love NASCAR might also enjoy a logo jacket and a model car for their favorite driver, or a tee shirt that tells the world he or she is a NASCAR nut.


But what do you do for cancer patients who don't wear baseball caps? My mother used to visit the gift shop in her cancer treatment center on a regular basis. She loved the "chemo cap" offerings in the store. There were wild, vibrant choices and dignified, classy choices. Sometimes there were even glittery choices, appropriate for wearing out in the evening. From turbans to scarves to caps, there were many attractive choices.


That's something families need to understand about cancer patients. It's tough to stand out in a crowd for the wrong reason. People want to be admired. When you walk into a room, you want people to think you look great. You don't want them to think about the fact that you look too bald, too thin, too pale, or too weak to stand. Cancer patients have a tough time going out during the holiday season and being admired for looking good. That can negatively affect one's self-esteem.


Hats and caps for cancer patients shouldn't just be about covering up what's missing. They should reflect the personality and style of each. If Aunt Mary is a wild woman, her chemo cap should shout this to the world. "Here she comes and she's on fire, baby!" If Uncle Joe is a quiet, intellectual man who is dignified and distinguished, he's not going to feel like himself in a baseball cap. Maybe he's the type for a nice black beret. What if Eveleyn has a gorgeous dress for the family Christmas party, but nothing to wear on her head? A pretty velvet turban or elegant scarf might just complete the look.


You may think it's not a big deal for cancer patients to just slap on a wig and be done with it, but the truth is there are many cancer patients who really don't enjoy wearing them.


My mother had a wig. She wore it less than a week before abandoning it for a chemo cap. But after a week of wearing the same two caps day in and day out, she was very frustrated. That's when I learned how to make her matching chemo caps and pants. She adored her coordinated outfits. Not only was she making a fashion statement by wearing vibrant prints, she was declaring that her personality had not been subdued by cancer. She was still in there in that body, and she was stronger than cancer.


The trouble with wearing the same chemo cap day in and day out is that you start to feel like it's a cover-up, a hair bandage, if you will. Your wardrobe revolves around the limited number of caps you have. Having a week's worth of chemo caps means you have choices of what you can wear. It lets you express yourself a little more.


But why not help a cancer patient have some fun? Why not buy a colorful hat or cap and embellish it? Why not add appliques, charms, buttons, and other fun things to decorate it? You can buy hats in department stores and sometimes even craft stores. There are stick-on appliques, iron-on appliques, and even sew-on appliques at craft stores. They usually just cost a couple of dollars. You can also find any number of charms, jewels, and other interesting add-ons. If Uncle Sid is a poker player, why not add some dice to a bucket hat? Or find a patch with a jack of hearts on it? It becomes his "lucky cap". If little Mary Catherine is a fan of dogs and cats, why not decorate a cap for her with charms that reflect this interest? If Aunt Bella is a fan of bling, why not find her a chemo cap that glitters?


You can go online for these. Some are made specifically for cancer patients, so they won't irritate delicate skin.There are websites that offer hats and caps for cancer patients. Headcovers.com is one:
http://www.headcovers.com/


There is a big selection to choose from, and that means that you can find something that really fits your loved one's personality. Whether it's a turban for your grandmother or a swim cap for little Jess, you can find a gift that will help your loved one feel more like everyone else, and that means he or she will feel better able to socialize with the rest of the world. Isolation is a terrible side effect for cancer patients. It's lonely to hide away at home, feeling unattractive. Don't let cancer control how your loved one celebrates the holiday season. Give your loved one the confidence to get out and get living.

For more tips on helping a loved one with cancer, view my guide:
https://sites.google.com/site/practicalcaregivercancer/home

The Practical Caregiver -- Cancer: "I PROMISE NOT TO BREATHE ON YOU!"

The Practical Caregiver -- Cancer: "I PROMISE NOT TO BREATHE ON YOU!": "Oh, it's cold and flu season! For most people, it's an inconvenience to be ill, especially during the holidays. But for cancer patients, it ..."

"I PROMISE NOT TO BREATHE ON YOU!"

Oh, it's cold and flu season! For most people, it's an inconvenience to be ill, especially during the holidays. But for cancer patients, it can be devastating. Cancer treatment centers often inform patients when they are vulnerable, and it's important for families to understand the risk posed by viruses and other threats to immune systems.

I remember being absolutely terrified when I went to visit an aunt who was battling cancer. I knew it was my allergies that had me congested, but I also needed to remember that she was very vulnerable to any kind of infection. I took precautions and worried through the entire visit. It's hard when someone you love has cancer and you want to be there.

When my mother was actively being treated for cancer, her medical team would periodically warn us that she was particularly vulnerable. That meant we avoided crowds and cautioned family and friends to forgo visits if they were ill. But it didn't mean life stopped for my mother. I still took her out and about, but I used some common sense. We avoided crowds. We took more drives, had more picnics, and explored the "unbeaten path". We even went to movie matinees in quiet, little theaters, where there were only a handful of theatergoers.

There were times, however, when we had to tell people to stay away. My mother was the first to ask any prospective visitor, "Do you have a cold?" Every family invitation included that question. Very often, especially in the winter months, the answer was yes. Many a family gathering was called on account of illness.

At first, some relatives tried to be creative, because they genuinely didn't understand the enormous risk of being exposed to viruses for a cancer patient. We often heard things like, "I promise I won't breathe on you!" People offered to come and sit in the corner. They swore they would not hug and kiss my mother. All they really wanted was to spend time with her.

The truth is that cancer patients really need to be protected when their immune systems cannot handle the effort to engage in a battle with another foe other than cancer. And yet, cancer patients need socialization, don't they?

Why not encourage family and friends to make video visits, through free service, like Skype? Why not encourage text messages, emails, phone calls, and even traditional cards and letters? Your loved one needs to know people care. It's important to have a support system, and that your loved one is covered by it.

You need to be vigilant when your loved one is vulnerable. It's a time to be protective.

Why should you make such an effort? Why does it matter? Your goal is to help your loved one have the best chance to survive cancer. Imagine how terrible it would be to put so much effort into the fight, only to lose to a common cold. Those complications are just not worthy of your loved one.

How successful were we at keeping my mother safe from colds, flu, and other threats? She was extremely lucky. She got through her cancer treatment without any problem. It was worth the effort. But there was also a positive side effect for the rest of us. Because we were so vigilant about hand-washing, sanitizing, and making sure to avoid bringing home viruses, we stayed a lot healthier, too. Not a bad way to live.

If you would like more tips on how to help your loved one through cancer, visit my website,
The Practical Caregiver's Guide -- Advice for Families Caring for a Loved One with Cancer:
https://sites.google.com/site/practicalcaregivercancer/home

The Practical Caregiver -- Cancer: CANCER AND THE HOLIDAYS

The Practical Caregiver -- Cancer: CANCER AND THE HOLIDAYS: "It's hard to have cancer at the holidays. If you're undergoing active treatment, sometimes the side effects are overwhelming. If your cancer..."

CANCER AND THE HOLIDAYS

It's hard to have cancer at the holidays. If you're undergoing active treatment, sometimes the side effects are overwhelming. If your cancer has spread, you may be limited in energy and emotional strength. How do you face the holidays with cancer?

One thing I learned as a caregiver for someone with cancer is that you must, as a family, be flexible. Some things are what they are. If you try to continue with family traditions, as if nothing has changed, you're likely to find your plans sadly undermined by reality. There's nothing worse than having your loved one feel more miserable because he or she can't enjoy the gathering.

You need to make an honest assessment of your loved one before you do any planning for the holidays. First, what is your loved one's energy level and what affects it? If he or she is having treatments, when do the side effects kick in? You may find that if you're planning a gathering and it's the day that your loved one is most likely to be affected by treatment side effects, you're going to cause more problems than you solve.

Sometimes changing the date of the gathering is more important than having it on the actual holiday. If you're used to celebrating on Christmas Day, but you know your loved one is going to be wiped out because of chemo, celebrate on Christmas Eve or Boxing Day this year instead.

If your loved one's energy is lower because he or she isn't functioning as well as past years, it's important to take this into consideration while making plans. Maybe what you really need to do is scale back the festivities this year. Make the celebration easier all around.

If you're hosting the party, keep the menu simple, but tasty. It's sometimes easier for your loved one to have a shorter family visit. Have the food ready to heat. If folks are used to coming at three, ask them to come at four-thirty. This gives your loved one a chance to rest before guests arrive. Instead of having lots of hors doeuvres, offer one or two choices and serve dinner twenty minutes later. Put the coffee in a thermal carafe or two, and keep your desserts uncomplicated.This way, your loved one doesn't have to dread the holidays. It's easier to be "up" for a party lasting two hours than one lasting four, if you have limited energy.

It's important that family members are supportive of the game plan and that they understand the need to shorten the festivities. You'll be amazed at how much fun you can pack into a couple of hours when you eliminate the complications.

If you're going to a family gathering, make an effort to gently explain the needs of your loved one and work with your hosts to find ways that will allow your loved one to enjoy the party without being physically or emotionally overwhelmed. Maybe the other guests can arrive at the normal time, but you and your loved one can arrive twenty minutes before dinner is served. Sometimes having the opportunity to skip some of the party means your loved one has enough energy to enjoy the important part of the occasion.

You may, however, come upon a brick wall with a relative who doesn't want to be flexible. Some people insist on following traditions, regardless of the needs of your loved one. In that case, you may have to explain that you just can't do things as you would in a "normal" year.

If the big party is too much for your loved one to handle, why not ask people to stop by for dessert and coffee with you and your loved one? By arranging for the group to come to your home after the dinner, your loved one still has the chance to socialize. Let's be honest. Dessert is usually the best part of dinner anyway, isn't it?

The important thing you need to always remember is that cancer patients don't want to be treated like the skunks at the party. They may need to rest more, they may not be able to cope with holiday stress as easily as they might have before cancer, but that doesn't mean they shouldn't be part of the party. Find ways to empower them to enjoy themselves -- leave the cancer behind for a few hours and just have a good time. 

A WORD OF CAUTION -- IF YOUR LOVED ONE IS VULNERABLE BECAUSE OF IMMUNITY ISSUES OR LOW BLOOD COUNTS, YOU MAY NEED TO PUT PLANS ON HOLD FOR THE HOLIDAYS, ESPECIALLY IF FAMILY MEMBERS HAVE COLDS OR EXPOSURE TO THE FLU. ALWAYS CHECK AHEAD OF TIME.

The Practical Caregiver -- Cancer: IS "THE JOURNEY FORWARD" PROGRAM FOR CANCER PATIEN...

The Practical Caregiver -- Cancer: IS "THE JOURNEY FORWARD" PROGRAM FOR CANCER PATIEN...: "I saw an ad in today's New York Times for a program that is aimed at helping cancer patients after they finish active treatment. It's called..."

IS "THE JOURNEY FORWARD" PROGRAM FOR CANCER PATIENTS A LIFE SAVER?

I saw an ad in today's New York Times for a program that is aimed at helping cancer patients after they finish active treatment. It's called "Journey Forward", part of the Wellpoint effort to improve health care for cancer survivors. Teaming with UCLA Cancer Survivorship Center, the National Coalition for Cancer Survivorship, and Genentech, they created a program that expects to improve coordination and communication between cancer patients and their oncology and primary care physicians.

The program provides tools to help patients to have the important discussions with their medical team on what steps can be taken by patients to manage the physical and emotional issues that arise for cancer survivors:

http://journeyforward.org

The goal of the program is to "...Prevent recurrent and new cancers as well as other late effects; Intervene for symptoms that result from cancer and its treatment; Coordinate the work of specialists and primary care physicians to ensure that all of a Survivor's health needs are met."

This means that each cancer patient will have a Survivorship Care Plan, and that will allow them to know they will continue to receive the same level of care even after active treatment of their cancer ends. Journey Forward promises to provide a bridge of care to help cancer survivors know what to expect for their future.

Components of the program include a survivorship tool kit, a medical history builder, a resources directory, and tips on talking to your doctor. This can help tremendously in understanding not only how cancer affects you, but what you can expect when active cancer treatment ends, and you're no longer making the trips to the center.  

On the surface, it sounds like  a great idea. How many cancer patients end active treatment and then feel like they are left dangling off of a cliff, unable to climb up or safely get down? With a plan in place, with information on what to expect and signs that are critical to monitor, won't this be a benefit to cancer survivors? There is surely nothing as frustrating as trying to figure out how to get back to living after cancer treatment. In the back of one's mind is always the fear that cancer will return, maybe in a different location. This program appears to tackle that issue, by offering a way to coordinate not only with the oncology team, but also with the primary care physicians.

The question is how will cancer patients view this program? Would it be helpful, after you are discharged from active cancer treatment, to know that your primary care physician will participate in your care and will be part of the team that supports you? I wonder how many cancer patients hesitate to call their oncology team when they notice a little symptom pop up here and there. Would it be less terrifying to call your primary care physician for a check-up?

For many cancer patients, there are long-term side effects from treatment, and some can linger for a long time, affecting one's quality of life as much as the cancer itself. Wouldn't it be wonderful to have a plan on how to address these issues and help you get on with your life?

The real test of the program will be in its beneficial results for cancer survivors. As more and more patients get involved and they begin to utilize the tools, it will become obvious whether the program offers a real opportunity for cancer survivors. My hope is that it is so well-planned and so careful about the little details of cancer management that it saves lives. The sooner cancer survivors notice what isn't right and get treated, the better. What good is surviving cancer if your quality of life isn't improved by the treatment? I hope this program does that.

TUMOR --TRYING NOT TO THINK ABOUT IT



"Now THAT'S a growth!"

 How can you not think about a tumor that is growing inside you when you've been diagnosed with cancer?

My mother faced this problem. Her tumor interfered with her ability to swallow food and even to breathe comfortably. For her, that tumor was a huge problem. Would it grow larger? Would it take over?

It's hard to tell yourself not to think about it, isn't it? After all, you know it's there. The scans confirm it. You've probably been tested for it. How do you cope with the reality that there is a growth inside you?

Sometimes the best way to cope with a situation is to meet it head-on. Information can be a lifesaver. When my mother found out she had this tumor, she also found out what treatment could do to it. Radiation made a difference. Chemotherapy made a difference. We made a point of asking a lot of questions. We wanted to know what her best options were. Slowly, but surely, she began to feel better as her cancer treatment kicked in. When she started, she needed oxygen round the clock, to help her breathe. But as the tumor began to shrink, she could leave that tank behind. She was able to resume a more normal life and do many of the things she loved to do.

It's hard to cope with your fear about a tumor. Some people may tell you to put it aside, not think about it, or even let it go. But sometimes confronting that fear can be helpful. When you understand what the goals of your cancer treatment are, when you communicate effectively with your oncology team, you have a better understanding of how that tumor will affect your life. Much of the time, there will still be unknown factors. Will you have weeks, months, or years? Can the tumor be kept in check? And if it does grow, how will the oncology team continue to help you?

Every day, there are new ways of attacking cancer. Over the years, I've met people who have survived for decades with different forms of the disease. I've even met several Stage 4 patients, alive and kicking, despite receiving a terminal diagnosis years earlier. The truth is everyone is different. The more you understand about your own situation, the better. Sometimes the hardest thing about having a tumor isn't the tumor, but the fear of the tumor and what it means for your life.

As for that tree, I've watched it for several years now. It continues to survive, despite that enormous growth. I am always amazed that it is still there when I come upon it during a hike. I expect it to die, but it doesn't. In the spring, the leaves still come out. In the summer, I am still shaded by its canopy. In the fall, it still sheds its leaves like all of the other trees in the forest. Somehow, it goes on. Maybe you will, too. Be hopeful. Fight hard. Embrace life. With cancer, it's important to see the forest AND the trees.

CANCER TAUGHT ME TO "ENJOY THE PARTY"

We don't always think of cancer as being a teacher, but it taught me some important lessons. One of the biggest was that it's important to "enjoy the party".

For many years, I spent a lot of time in the kitchen at the holidays. Coming from a family of non-cooks, I was the one in the kitchen with my mother, fixing the feast for the holidays. Even my mother wasn't a big fan of cooking, although she was good at it. Usually, she would bake her pies the day before, and then get up early in the morning, to start the turkey. I often filled in with the rest of the dishes, with relatives contributing their specialities.

Over the years,  I cared for her when her health began to fail. She still wanted to participate in the cooking process, but her energy was limited. That's when I became her sous chef, chopping and slicing, so that she could do the actual cooking. It was important for her to feel that she was making a meaningful contribution to the gatherings.

But when she was diagnosed with lung cancer, everything changed. She was too fatigued from chemotherapy to stand in the kitchen, cooking for hours. Neuropathy robbed her of the use of her hands and feet. It's hard to cook when your fingers can't even do simple things, like button your own shirt or tie your own shoes.

And yet, my mother was still determined that we would entertain the family. There was nothing she loved more than a big gathering with lots of laughter. I learned to get the meal together in stages, so that most of it could be re-heated when the guests arrived.

As time went on, I continued to sharpen my organizational skills, trying to find ways to make my life easier. After all, my mother was still going for treatments and medical appointments, and that meant we spent a lot of time at the hospital and in doctors' offices. I didn't have a lot of time to fuss with food.

But more than that, I learned over time that it wasn't so much the food that made the party. It was the people. Without family and friends gathering to share, a meal is just a meal. With the people you love all around you, there is laughter and love.

This year, Thanksgiving is going to be less complicated. I've got my pie crusts thawing in the refrigerator, ready to become apple pie when I chop my apples tomorrow. I made them in the Cuisinart earlier this week, with Julia Child's food processor recipe. My corn muffins are in the freezer, baked fresh last week. I made a double batch of cheese sauce, used half for tomorrow's cheddar broccoli and the other half for tonight's macaroni and cheese. I cooked the turkey today, so it can be sliced up, piled on the big casserole dish of stuffing I will make tonight, and moistened with the canned gravy I bought to save myself some time. Tomorrow, I will try my first pumpkin souffle, as a side dish. One of the guests is bringing a wonderful cranberry-walnut tossed salad with gorgonzola. I'll slice some cheddar cheese and make a platter with whole wheat crackers and red seedless grapes. If I have the time, I might even make a dip to serve with carrot and celery sticks. But one thing I'm not going to do is stay in the kitchen tomorrow.

Cancer is a big disease and the lessons it teaches us are big, as well. Tomorrow, I will join the party. I will listen to the stories, share the laughs, and be a part of the moment. I will appreciate the opportunity because time is promised to no one, and I know now that I should not wait until the next party to get out of the kitchen. We have to seize the day and embrace it. In the end, it's not the little things that really matter. It's the life you have. Make the most of it. Enjoy the party.

CANCER IS LIKE AN AUTUMN HIKE

You're probably wondering how in the world I can compare cancer to an autumn hike.
I'm not talking about the early autumn days, when the leaves are still on the trees and everything is painted in glorious color. I'm talking about the later days, when the leaves have fallen upon the trail, and when you look around you, the trees are bare.
This is the time of the year when footing is precarious. You never know what lies beneath the leaves, but every step of the way brings the crunching sound of your boots on the ground. Sometimes you slip, lose your balance, and start to slide.

It's the time of year when the trail disappears under the vast sameness of the ground cover, and you have to rely on your keen eye to find the subtle dips and rises of the ground to guide you.

I go hiking with my little Yorkie friend. Any other time of the year, she is scampering through the woods, bold and curious. She climbs boulders and hops right over big logs across the trail. She feels confident in the woods, exploring every nook and cranny and hole. But in the fall, she has trouble moving through all those dead leaves. Even she doesn't know what lies under them, and sometimes she falls over tree limbs and rocks. She becomes timid. The crackle of the leaves must be deafening to her.

With cancer, you never really know what lies beneath the surface. You hope for the best, but sometimes you can stumble over the unseen obstacles. It's hard to know what to do and where to go, because when you look out on the horizon, all you can think about is that cancer. You sometimes wait for it to crop up unexpectedly. And it's so hard to think straight, until you know that it is in remission.

And that's why cancer is like an autumn hike. You go slowly. You study the terrain. You look for the clues to point you in the right direction. You try to find your way using all of your senses.

But there are also trade-offs to being on the trail in the fall. This is the time of year there is more sky above you. You can see further, because the trees are bare, so you get a broader view. In the vast sameness of the woods, where all you see are dead leaves on the ground and bare trees, you can also begin to see other things when you look. The treasures of the forest begin to reveal themselves to you. There might be a small grove of new pines emerging, or an unusual mushroom with a crooked cap on its head. You might discover, as I did today, the remnants of an old stone wall, from a couple hundred years ago, half-buried on the wooded hillside. It could even be something as simple as an aerial dance performed by winged insects, caught in a sunbeam. These things only appear when you look for them. Sometimes you have to force yourself to find the beauty in the never-ending brown landscape of fallen leaves.

To a hiker, the forest is never the same experience twice. Every hike looks and feels different. Things change, sometimes evolving over time. But you come to rely on your senses to help you navigate the unseen and unexpected. You train yourself to look for the pleasant surprises along the way. Let cancer be more than just a disease that affects your life. Let it be an opportunity of which you take charge. You may not be able to change the season of your life, but you can choose what you discover within it. Find the treasures that life offers along the way. Appreciate the goodness you stumble upon. Celebrate the love that shows itself. These are the things that really matter most.

BATTLE FATIGUE FOR CANCER PATIENTS

I was having a conversation recently with a couple of baby-boomers who had been walloped by the economic crisis that is squeezing the middle class. After a sustained unemployment situation challenged their savings, they were starting to get back on their financial feet, but it will be a long struggle for them to regain economic stability. With new income going out to pay financial obligations as soon as it arrives, it's hard to feel like there is much reason to carry on. Add to this some other stressful changes in their lives, with the death of a loved one and an empty nest as their child entered college, and they are right smack dab in the middle of a psychological obstacle course.

How does this apply to cancer treatment? The subject arose as to what they would do if either developed a serious illness. The feeling was that they wouldn't bother to take extreme measures to treat the illness, because who wants to live a long life if it means suffering?

In reality, this couple is suffering from what amounts to battle fatigue. People who face prolonged struggles often come to have this kind of mindset. When it occurs during treatment for a manageable disease, it can imperil the outcome.

Sometimes patients who have been treated for cancer more than once come to feel that it's not worth the effort. Or that they are burdening their families by seeking treatment for a recurring disease. When this kind of situation arises, it's important that caregivers appreciate what is really happening and why.

If your loved one seems reluctant to seek treatment, perhaps the biggest problem isn't the cancer itself, but the battle fatigue that accompanies it. What are the chances that your loved one can get past the obstacles and go on to live comfortably with the disease under control for several more years? Is there a reasonable expectation that the cancer can be brought into remission with treatment?

Sometimes the hardest job for a caregiver is to understand the real prognosis for the disease. When people talk about quality-of-life care, some will avoid it until the last minute, because they hope desperately for a cure. They're willing to fight the fight and take on all the discomfort that goes with that. Some of these people would benefit from understanding the reality of their prognosis, that end-of-life care can be a better option. Sometimes people need to live their lives more than they need to pursue the potential brass ring. But other people sometimes opt for surrender long before that may actually be the best option. If a disease is manageable and the quality of life can be good with treatment, people need to understand that a negative mental attitude can prevent them from pursuing viable opportunities. If there is battle fatigue, patients often won't see the potential for a future. If they are scared from their emotional and physical battles, they will think it isn't worth fighting anymore.

Cancer treatment is always more than just surgery, radiation, and chemotherapy. It's about helping the patient and the family understand that there are so many details in treating the disease.

Every combat veteran on the battle field dreams of the day he or she can go home again, to live in peace and leave the war behind. Your loved one is really no different. Cancer is an enemy that wages war with a ferocity that can intimidate. Help your loved one to recognize the realistic opportunity to survive. Keep the home fires burning. Work on the morale of your loved one. That what real support is all about.

PERSPECTIVE IS EVERYTHING -- HOW AN ARTIST'S EYE SEES CANCER

As an artist, I value perspective. As a caregiver, I've found it can make all the difference in how a cancer patient looks at life.

Some artists like to work outside, capturing the feel of the scene they are painting.  They spend the hours immersed in the fluidity of the scene, as the light changes and the breeze blows. Me? I'm more interested in capturing a moment in time, and I like to take my time in examining it in all its intricacies. I take digital photographs and study them. I learned long ago that my mind, if allowed to wander, will imagine what is there if it doesn't have enough information on what I am looking at, and as a result, my paintings aren't accurate. To me, there is great beauty in reality, but only when you look for it, and only if you have the capacity to appreciate it.

When I start to paint a canvas, I block out the shapes. As I move forward, I begin to fill them in, stroke by stroke. At first, my mind only takes in the big picture.

Unfinished Canvas of Parker Memorial Park, Branford, CT

In the case of this painting, still a work in progress, I see the shapes of the stone wall, the rocks, and the treeline. Once those are in place, I start to focus on the details. There are changes in color in the trees, the water, and the rocks. Once I get those done, I notice there are people in the park, and picnic tables, benches, even a car. As I keep working, I start to see that the shadows come into focus, and there is a hidden roof there and a couple of boulders I missed earlier, when I was too busy trying to fit everything in. I even discover that there is a heart shape in one of the rock formations in the foreground. It's little things like that which I so enjoy discovering as I paint. In every painted scene, there are secrets that only reveal themselves to me when I have enough understanding of the scene I am painting to recognize them.

How does all this fit in with cancer? When you are first diagnosed with it, you're faced with the task of blocking it all out, just like I block out each of my paintings. You have to fill in the sections and put things in their proper place, before you can see the details. But as you go along, you will find that there are subtle differences that can be good or bad.

The first thing you see in the big picture for cancer is that it can be overwhelming in its power. But after the big picture, you start to look at the big blocks of information -- not all cancers are the same. There are different kinds and they don't all have the same results. Some people live with cancer for decades. Some people don't. Once you understand that, you start to focus on the details. Survival rates are up for certain kinds of cancers. New treatments are discovered constantly, improving life sometimes for weeks, months, or even years. Why does it matter if you can live another few weeks, months, or years? Because things can happen in that time that can change your life. By the time you get down to the little details, you begin to see that time is your friend. It gives you options for treatment, for quality of life, for making choices. You start to understand that, as a cancer patient, you may not have the choice to have cancer, but you can start to make decisions about how you will live with cancer. And you also start to understand that while your life may be limited in some ways by your disease, you often have a greater understanding and appreciation of what really matters in life than a lot of people who are never forced to really examine their lives. Life matters to you because it's under attack by cancer, and you have to navigate your way through the maze of treatment options and choices. Some people never discover just how precious life is, or why we should celebrate the good moments we have, because in the end, life is always too short. Live every day like it matters, and it will.

LOSING INDEPENDENCE DURING CANCER TREATMENT

My mother lost her confidence in herself when she was on chemo, and with good reason. She was weak and had great difficulty just walking any distance. But she wanted to drive her car again. She was extremely frustrated that the doctor suggested she practice off-road first, to make sure she would have the strength to stop the car suddenly and to make sure she had enough concentration to keep her attention on the road. One day, I took her out driving. It was a disaster. She had no idea where she was. Her rhythm was off. It was like watching a movie in slow motion. She was close to tears when she accidentally scraped the car mirror on the side of a building. For me, it was rather like taking a teenager out for driving lessons. I had held my breath several times as we came perilously close to objects. The truth was she was in no condition to drive, and it had little to do with her age. It was all about the chemo and its effects on her nervous system.

If your loved one is going through chemotherapy, it's important to be sure that he or she is capable of doing tasks like driving. The last thing you want to do is send someone on the road who poses a risk to the public. Having to tell your loved one that he or she shouldn't drive is tough. There's no real upside to losing your independence, even if it's for a couple of months. Suddenly, you go from being an adult with a life and the capacity of making decisions for yourself, to someone who requires transportation wherever you go and you are forced to rely on the kindness of the people who love you, without really being able to give back. That little imbalance creates a real sadness in a lot of people, and rightly so. Imagine being too weak to do your normal activities, and now suddenly, you actually are dependent on people for everyday needs. For some people, chemotherapy isn't this devastating. They manage to function quite well while chemotherapy drugs are coursing through their systems. They continue to work, exercise, and drive without problems. Others are totally knocked off their feet.  For most people, though, the effects are somewhere in between. Different chemotherapy drugs have different side effects. But they all have one thing in common. They are designed to affect the cancer. It's difficult for your loved one to keep that in perspective when it means giving up his or her independence. Your job, as caregiver, is to help balance that sense of loss.

How do you do that in a reasonable way? If your loved one has the energy and the inclination to get out and about, but can't drive, the solution is simple. You can drive your loved one or arrange for family and friends to do the driving. But if you want your loved one to feel less guilty and more relaxed about his or her dependence, make it a social event. Don't make it seem like it's a chore for you.

I learned this the hard way. Sometimes, when my mother was most frustrated, she would pick a time when I had already made plans to do something, and then she would announce she wanted to go out. Part of this was the self-pity she felt. She was mourning what she couldn't have -- the independence to pop out to the store when she wanted to go. But it was inevitably when I was on my way out the door to do something I needed to do for myself. Sometimes, I would offer to take her where she wanted to go hours before I had to be somewhere. And inevitably, she would be late. I would feel myself getting frustrated because it was going to ruin my plans. It took me a while to realize that it was her way of feeling some power, albeit at my expense. That's when I realized that I had to do what I had to do, but I could adjust my plans to times when I knew she wouldn't be able to stop me.

My mother was not a morning person, especially during chemotherapy, and I learned that if I made my plans during the hours she was too fatigued to want to get out and about, I could have my own life and still meet her needs. She seemed to come alive from 11 AM to about 3 PM, but after that, she needed a nap, especially if she had been very active during the day. That window of opportunity kept me sane. I made it to my own medical and dental appointments, got to the gym for my daily workouts, and took the dog for her walks, all while keeping my mother as active and social as possible. I also did my best to help her channel her energy in more positive ways, to help her feel more in control of her life, so that she didn't try to regain her sense of power by thwarting me.

When people are under great stress, they will say and do things that are counterproductive. As a caregiver, you have the responsibility to be the voice of reason, and that requires that you exercise your mental facilities to figure out what that is. Sometimes it's hard to know where the frustration is coming from and what the solution to the problem is. Imagine what that's like for someone on chemotherapy, with your nervous system under attack as the drugs flow through your body in search of cancer cells. Your body is going through changes that don't necessarily feel good to you, and you're expected to endure these side effects without falling apart physically. What about your emotional well being? What about how you feel?

That's the problem with chemotherapy. It affects your body in ways that can be confusing and upsetting, and when your body feels like its been turned upside down, your emotions can run rampant, all while you don't necessarily have the capacity to understand what ails you. Many people vent their frustrations on the people taking care of them. At times like these, it's a good idea to develop a thick skin, bite your tongue, and recognize what you're seeing in your loved one.  You have to stand up for yourself in an appropriate manner, so the relationship can regain a more natural balance, but you have to choose your words carefully and appeal to the goodness in your loved one. No decent person enjoys losing emotional control of himself or herself, and when it's compounded by a loss of physical control, it's even scarier. That fear can add to the confusion of the situation. But if you recognize it for what it is, you can help your loved one avoid bad behavior that is driven by fear and frustration.

SAVING MONEY DURING CANCER TREATMENT

A number of families find their expenses go up significantly when a loved one is undergoing cancer treatment. Obviously, there are prescription drug costs, in addition to bills for medical treatments, and a lot of these aren't always covered by insurance. But there are also often a lot of out-of-pocket expenses. These can wreak havoc with family budgets. How can caregivers manage these changes?

I noticed a big change in the family grocery bills when my mother was having cancer treatments. Why? Because a number of her medications had severe side effects that required buying over-the-counter remedies to treat them. Prescription drugs like Prednisone, which help with related breathing issues, require an over-the-counter drug like Prilosec to address the negative side effects, such as acid reflux disease.  Some drugs cause side effects like constipation, so the use of laxatives and fiber may be directed by the physicians. Every cancer patient's needs will be different, according to his or her situation, but one thing is certain. There will be an increase in spending, to accommodate these changes.

If you're used to shopping at a traditional supermarket, you're going to have to find ways to cover the added expenses that cancer treatment can bring. Plan the weekly grocery shopping carefully. Shop the weekly specials and buy in bulk if these are items the family usually uses. Clip coupons for more savings. A number of over-the-counter remedies can be bought at reduced prices, through manufacturer's coupons and discounts or by purchasing them in larger quantities.

Consider joining a warehouse club, like Sam's, B. J.'s, or Costco. Normal household items, like paper goods and laundry products, are expensive, and if you buy these at a warehouse club, you can cut your costs. It's also true for fresh produce, dairy items, and prepared or frozen meals. This will save money for the overall family budget, but if you also purchase over-the-counter remedies in bulk, you can really cut down on costs.

If your loved one has lost a lot of weight and needs to have products like Boost or Ensure, you can save money at warehouse stores, or even at Walmart. My mother hated the cloying sweetness of nutritional supplements, so a nurse shared her recipe for protein shakes with me. The shakes gave my mother the extra calories and protein she needed, but tasted better to her, especially when I added ice cream to them. I bought the protein powder in big cans. At the supermarket, it was $22, but at Walmart, the same product was under $14. That's a big savings when you're mixing up shakes two or three times a day. I saved the nutritional supplement drinks for emergencies, and that worked out well. Sometimes you have to be creative in how you approach the situation, and you have to make it work for you.

It's also helpful to realize early on that your loved one's cancer treatment will have a cumulative effect on the family finances. If you can understand this, you can avoid some of the pitfalls that a number of families fall into at one point or another. Cancer treatment is expensive, and by conserving the financial resources of the family in little ways, you will be better able to meet the unexpected costs that crop up along the road. 

If your loved one did the "heavy lifting" for the household, mowing the lawn, raking the leaves, doing the garden, you may have to take over some of these responsibilities or temporarily hire someone to do it. If you live in an area of the country hit by rough wintry weather, you may find yourself shoveling snow, chopping ice, and sanding the driveway and sidewalks, or paying someone to do it for you. These bills can add up quickly, which is why it's really helpful to conserve money where you can throughout the cancer treatment. 

What if you don't actually need the money you've saved during cancer treatment? Why not use it to take a family trip? Reward yourself and your loved one by having some fun once your loved one gets through with chemotherapy, radiation, and surgery. Not only will you have a chance to make some happy memories, you won't spend your time worrying about how you're going to pay for it all.

And sometimes if your loved one knows there is a rainbow at the end of the storm, it makes it easier to get through it. Why not start planning for a celebration trip during your loved one's treatment? You don't have to dream big. Sometimes that can be overwhelming. But think about something that you'd both enjoy doing together. Maybe it's a weekend at the shore, just enjoying quiet walks on the beach and family cookouts. Maybe it's a few days with the kids at Disney World or Universal Studios. Maybe it's a trip to the city, to see a musical, visit a special art exhibit, or enjoy a concert. Maybe it's a cruise to the Caribbean or a trip to Bermuda. It's a lot easier to pinch pennies when you have a positive goal, and your loved one will be able to appreciate your efforts if he or she thinks a trip is your main purpose in cutting expenses. Cancer patients often feel guilty that they are using up the family's financial resources. By giving your loved one hope for the future and by protecting the family budget, you're extending your care-giving above and beyond the physical needs of your loved one. You're also taking care of the heart, the head, and the spirit. We all need to feel free to be more and experience more, but in order to do that, we have to appreciate how things can build up into problems if we don't take preventative measures to prepare for the rainy days ahead. 

HOW CAN CANCER PATIENTS STAY PRODUCTIVE IN THE WORK PLACE?

How many cancer patients waste their work expertise and experience during cancer treatment? How many are forced to quit their jobs as a result of being physically incapacitated? How can they be supported in the work place, so that cancer doesn't take from them their livelihoods and their future opportunities?

Many people manage to get through cancer treatment while still working. They make arrangements and handle the rigors with grace. But there are others for whom the personal cost of cancer treatment is much more severe.

If your loved one is struggling with this issue, consider a few things before throwing in the towel. Analyze the strengths and talents he or she brings to the job. It may help provide opportunities to keep working during cancer treatment. Can his or her employer provide administrative duties that allow your loved one to be productive while still conserving energy? Can your loved one reasonably scale back some of the normal responsibilities of the job, just long enough to allow the cancer treatments to have a positive effect?

Consider the plight of a teacher who may be going through chemotherapy. How can a school system accommodate the issues he or she might have? We know that kids often are a breeding ground for germs, and a teacher under chemotherapy treatment, with a weak immune system, really shouldn't be exposed to such risks. Is it possible for the school system to offer this teacher a temporary position, possibly as an educational coordinator, a developer of curriculum, or as a long-distance tutor? Maybe a teacher can teach home-bound students, via Skype or another Internet service. It not only cuts down on the risk of infection for the teacher, it provides a home-bound student with appropriate educational resources that might otherwise be missed. Having a teacher who is also a patient can be inspiring.

Sometimes it's hard for patients in the service industry to continue working. Chefs and cooks need to be physically capable of moving about in order to perform their duties. Restaurant work can be demanding. In the interim, what about your loved one working as a personal chef? If you pitch in and help with the grocery shopping and driving duties, would this work?

Nurses and other professionals who are going through cancer treatment have a difficult time remaining on the job in their normal capacities, but certainly there are other opportunities within the medical field, even on a temporary basis. Maybe your loved one can scale back his or her work load to a half day until physically capable of resuming a regular shift.

What about cancer patients who serve in law enforcement? Can't they also be accommodated in practical, useful ways by their employers? Certainly, it's not wise to send a cop out on the street if he or she can't run or keep up with the rest of the team, but there are always cases that could use another review by a seasoned investigator, who can pursue information that was never followed up, and even make phone calls to clarify cases. It's certainly not ideal, but having the opportunity to remain on the job in some form is usually preferable to being cut loose. Maybe there is a law enforcement study that needs doing, or community services that can be improved. It's important for cancer patients who are willing to work to be reasonably accommodated.

If your loved one has a job that allows for Internet communications, it may be possible for him or her to telecommute to work, handling a lot of the normal duties of the work place from home. Even if he or she needs to occasionally go to the office for important meetings, it makes it a lot less stressful if the bulk of the work can be done in between periods of rest. Salespeople, financial advisers, stockbrokers, and others can still function on the job, even if it's in a more limited capacity. Sometimes it's a matter of scaling back the number of clients who can be served, or joining with other colleagues to get the job done in the interim.

Real estate agents may feel they have few options while undergoing cancer treatment, but what about pairing with a partner during cancer treatments? If there is another agent who works part-time and is willing, why not share the load together? Maybe it's a mom who wants to be home for her kids or a retired realtor who doesn't want a full-time position. Your loved one could continue to work part-time, with a lot of the work done on the Internet. Having a partner could help make the sales.

It's important for your loved one to feel like he or she is able to stay abreast of developments in the field. That means keeping one's hand in the game somehow. By working part-time, even if it means job-sharing, it may allow your loved one to have a smoother transition back into the work force, when the cancer treatment is ended.

Another option is to take university classes for credit. There are a number of opportunities to pursue online education for people in many professions. Some employers would welcome the opportunity to allow cancer patients to use their down time to improve their professional skills. Some employers may even want to pay for these courses.

There are also times when employers appreciate creativity on the part of employees who show initiative. If your loved one has a special project he or she thinks will help the company or agency, why not encourage pursuit of this goal? Maybe your loved one had a great idea to try a new management training module, or wanted to develop a new client list. Now's the time to offer it up. Or maybe your loved one has an idea for a new product or service. Why not use the time during cancer treatment to do the research and put together a package?

Just because your loved one is going through cancer treatment and finds it too overwhelming to work full-time, that doesn't mean he or she has to retire or quit. Working is important to the psyche, and feeling like a contributing member of society is very important. Cancer patients just sometimes need support and accommodation to help them remain in the work place. Employers who recognize this and encourage it will often find that this is a win-win situation. Cancer patients are still living, breathing people with a lot to offer, and when they feel they have a future, they often will pour themselves into the opportunities they find.

HOW DO YOU HELP A CANCER PATIENT KEEP GOING?

Some patients' cancer is caught early on, when it's possible to intervene and predict a rosy future. Other patients find their cancer has advanced to late Stage 3 or Stage 4 by the time it's discovered. For them, doctors often scramble to find acceptable options that can have a positive effect for cancer that's already out of control. But for many patients, their cancer is caught in that middle ground, when it's not really horrible enough to be critical, but also not easily treated and forgotten.

 It's so hard to keep the fears at bay when there is uncertainty. When a patient hears that the prognosis is good, the glass is more than half full, so it's easy to keep one's optimism going. But when a prognosis is "wait and see", and the patient is looking at the potential of having repeated treatment courses over the next few years, the glass is less than half full. How does a heart not feel disappointment over the prospect of handling all that uncertainty?

More importantly, how long will it take for doctors to feel confident that the cancer has been controlled enough for a patient to begin planning his or her future? Two years? Five years? During that time, there will be no promises, no guarantees, no certainty that the treatment is working.

How does a caregiver help a cancer patient get through that long, seemingly endless wait? How can you help your loved one stay focused and motivated, even after cancer treatment ends and the next months are spent waiting to see the results of the next body scan?

First, consider this. What are the goals of your loved one over the next year, and are they reasonable? Sometimes cancer patients stop living while they wait to find out if they are going to survive the cancer. Imagine putting your life on hold until you know. Think of what that means. You can't make any long-term plans until you're sure you will be available the following year. What does that say about this year? That it's not worth living?

Second, what is the condition of your loved one at this moment in time? What is he or she capable of achieving and what kind of support will help him or her get it done?

Third, how will you feel if you let your loved one languish during the wait for news, especially if it turns out the news isn't good? Will you have regrets that you didn't take the time to help your loved one to complete achievable goals now?

If your loved one is treading through that great "unknown", when it's impossible to know how all of this will work out in the end, seize the day. Take what is before you and make it matter. Understand the role of worry and stress on patients and the damage that can result. If your loved one spends the next year in an emotional limbo, that will result in greater stress, and that stress often has real physical manifestations. Your goal, as a caregiver, is to help your loved one be as healthy as possible under the circumstances. That means understand that stress over time can do great damage to the physical body, but it can do even greater damage over to the heart and mind.

If your loved one puts his or her life on hold while waiting for the results of cancer treatment, he or she will begin to direct all energy towards waiting and wondering. It becomes a habit to stick to the sidelines of life. When the wait is over, what will your loved one have to show for all that sacrifice? If the news is good, your loved one will need to get back to normal activities, but he or she will still have to work through that anxiety and fear that the cancer is still dangerous. If the news is bad, he or she will have lost all the time spent waiting, without a positive outcome waiting in the wings.

That is why it is so important to embrace the here and now and make it work for your loved one. He or she probably won't be able to climb mountains or leap tall buildings, but if there is a dream that's achievable, now's the time to go for it.

Sometimes it's not easy to live in the here and now. Your loved one may hesitate for fear of not being able to finish reaching for a dream. That's why it's important for you, as caregiver, to help your loved one focus on the achievable goals and to make the effort to get to each finish line. Build on each success as it's achieved. When your loved one reaches the first, start planning the second. Not only will this help improve the confidence level, it will create a more positive momentum. You'll both find the long wait feels shorter and that time goes by more quickly because your loved one is focused on living, not dying. However things turn out, you will always have these moments that you shared, and the goals that are reached will be part of your loved one's history, regardless of what course cancer takes.