December 6, 2013 | by Hiu Chung So
The first in a series on getting through the holidays . . .
The holidays can be especially daunting for cancer patients already coping with the impact of their diagnosis, treatments or side effects. Gift shopping, meal planning and social functions are stressful enough on their own. When compounded by a potentially life-threatening illness, they can seem overwhelming. And of course, patients may be facing myriad spiritual and psychological issues.
But cancer-care experts say that, with some planning and strategizing, patients can get through the holidays with minimal stress and maximum enjoyment – and perhaps be the stronger for it.
For starters, patients must strive to have realistic expectations, says Natalie Schnaitmann, L.C.S.W., director of operations at City of Hope’s Department of Supportive Care Medicine.
“If patients try to be everything for everyone at every occasion, they are setting themselves up for failure,” Schnaitmann said. “Rather than expecting all the festivities to be perfect or the way they were pre-diagnosis, patients should work within their current reality.”
To help patients do that, Schnaitmann offers the following tips:
1. Normalize emotions, even negative ones. The holidays are a time of joy and celebration. Although it's not uncommon to feel sadness and loss this time of year, patients may feel an obligation to be grateful and joyful. “It is completely OK for patients to experience sadness and a sense of loss about not being able to partake in the festivities as they usually do, and it is much more constructive to acknowledge and address them directly than to bury them in a pretense of holiday cheer,” Schnaitmann said. She also encourages patients to discuss these emotions, whether with a significant other, in a support group or with a professional.
2. Learn to say ‘no.’ Because holiday activities can take a physical and emotional toll, cancer patients – who already have limited physical and emotional energy – should feel free to decline any that seem too draining. When they do attend an event, they should consider limiting the duration or intensity of participation to a comfortable level. “For example, rather than stay for a whole meal, patients may want to just drop in for appetizers or desserts to avoid becoming too fatigued,” Schnaitmann said.
3. Have a script ready. For social functions, Schnaitmann advises patients to think through possible uncomfortable scenarios and prepare responses to potential questions about their illness and treatment. “When they go in equipped with a plan, patients will feel more confident and less vulnerable,” she said. In addition to having scripted replies, Schnaitmann says, patients should also have an escape plan handy so they can take a breather or leave early when situations become too exhausting or difficult.
4. Delegate responsibilities. Because holiday tasks such as shopping, gift-wrapping, decorating and hosting can be physically demanding, Schnaitmann suggests that patients enlist the help of family and friends for these duties. “This is actually beneficial for the patient’s loved ones too, since they often feel helpless while the patient is undergoing treatment. Asking them to help out with specific tasks gives them an opportunity to make a positive contribution,” she said.
5. Be creative. Just because treatment or side effects interfere with longstanding traditions doesn’t mean the rituals have to be abandoned entirely. Simple, flexible tweaks can include decorating a patient room instead of a tree, or holding the holiday meal around the bed or a recliner instead of around a dining table. “Other important rituals, such as a special toast, breaking of bread or a prayer, can be held within patient rooms or even over Skype,” Schnaitmann said. “Think of what is most important about the tradition and the possible creative ways to sustain that.”
Most important, Schnaitmann implores patients to communicate and reach out for help.
“This can be with their significant other, their social circles, their communities and, of course, with us; the Department of Supportive Care Medicine at City of Hope comprises more than 80 trained professionals – including social workers, chaplains, pain specialists, psychologists and psychiatrists – to help patients maximize their coping strengths and support them through whatever psychological, social and spiritual issues they may encounter during this time of year.”