A Journey with Cancer

April 4, 2008

Have you ever stopped to think about what it would be like to receive a diagnosis of cancer? Unless you have been through the experience, you probably don’t think about it much, perhaps not at all. I’ve been lucky in that I’ve never been diagnosed with cancer, so far anyhow but several members of my close family have been down that road. For many years, I have found myself drawn to the world of cancer care. It’s a very special place and it feels like a privilege to me to be a part of it. Having recently completed some training modules in psycho-oncology, I’d like to share a little bit of what I’ve learnt with you.

When someone receives a diagnosis of cancer it is the beginning of a long, lonely journey. It’s a rocky ride both physically and emotionally, not least because of it’s never ending nature. People’s personalities, coping styles, expectations, and past experiences all influence the impact of a cancer diagnosis. Cancer threatens fundamental assumptions about our lives. Where life was once taken for granted, that luxury no longer exists. One’s very survival is threatened and that wonderful sense of certainty and expectation of continued life and health, is destroyed. This pervasive sense of uncertainty probably characterizes the journey with cancer more than anything else. It often lessens when things are going well, but it is a feeling that never completely goes away.

The experience of having cancer shakes your confidence in a profound way. You feel disconnected from the world. While excellent medical care is available today, many people report that they feel emotionally stranded.The demands of the illness and treatment can place a great strain on relationships, and significantly alter family dynamics. Family and friends may be just as emotionally affected by the illness as patients themselves, and sometimes more. When my own brother was diagnosed with terminal cancer, I found it very difficult to watch my parents going through the pain of losing a child. My brother was 48 when he died but nonetheless, the grief experienced by my parents was out of order with the natural process of life.

Patients experience many different types of loss as a result of illness. Self-confidence and self-esteem is shaken and a loss of identity can occur. A long-term illness affects the sense of control over one’s life. To counteract this, patients need to have meaningful and realistic goals set, to help to reinforce their sense of personal control. It can also be invaluable to speak with someone else who has been through a similar diagnosis and treatment, “the voice of someone who has been there”.

On completion of treatment, the journey is far from over. It’s not easy being a survivor of cancer. Patients experience a period of re-entry into the world where they are confronted by a future which they thought they might not have. They also have to undergo a process of learning to live life with the possibility of recurrence of cancer. This fear usually recedes with time as significant milestones are reached but it never fully goes away. Re-establishing hope for the future can take time. It’s not the same future that was taken for granted before the diagnosis.

I have read many books written by people who have been on a cancer journey but without doubt, the best one I’ve ever read was written by Kate Carr and it’s called “It’s Not Like That, Actually: A memoir of surviving cancer – and beyond (Vermilion: London 2004). It is a moving and honest account and it provides supportive and empathic advice for anyone living with cancer, their own or that of someone they care for. I cannot recommend it highly enough.

I dedicate this post to Laura ‘Distant Rambler‘, a blogger whose braveness and zest for life while in the darkest depths of her own difficult journey with cancer, is inspirational. Thank you! Laura.


Hands Off!

April 2, 2008

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As I left the nursing home yesterday evening having visited my parents, I spotted a notice in the front hall which left me seething with rage. It seems the HSE has identified another niche market to get it’s grubby hands on, and care for the elderly is about to suffer the same fate as the public health service.

In Ireland, there is a huge shortage of long term care beds and this has placed great strain on support services. Our acute hospitals our filled with elderly patients who are well enough to be discharged but who are unable to live at home without a support structure in place. The government pledged to address this problem by funding better homecare packages and providing extra long stay public beds in the nursing homes. However with the HSE cutbacks, homecare packages were the first to go. The public health nurses are doing a brilliant job but they are severely limited through lack of funding, in the services they can provide to assist old people to remain in their own homes. With Ireland’s ageing demographics, there has been a sequential increase in the number of dementia sufferers and this is placing an increased burden on support structures. As a result, more and more families have to resort to seeking nursing home care for their loved ones in order that they can end their days in comfort and safety.

Now it seems that this safety net is about to be pulled from under their feet. The notice that caught my attention yesterday was in effect, an apology from the management of the nursing home to the staff, residents and their relatives for cutbacks which are due to be implemented shortly by the HSE. Instead of increasing funds to provide for much needed improvements at the nursing home, the HSE now plans to deplete services and I’ve no doubt that this action will be replicated at nursing homes across the country. All development plans have been put on-hold and an embargo has been placed on staff recruitment/replacement and on the renewal of equipment and supplies. One large ward is due to be closed down completely resulting in the loss of a significant number of long stay beds. While these nightingale-style wards are a disgrace as they reflect a bygone institutional age rather than a care setting which is home from home, they should not be closed down without first being replaced by newly designed rooms. This action is very similar to the HSE’s recent closure of various acute care services around the country before any of the promised centres of excellence have been developed. It makes no sense but then what else have we come to expect from the HSE?

So instead of planning and implementing the necessary changes needed to provide for proper and effective care for our older people, this government has opted to target care services for the most vulnerable in our society in order to save their own skins. I’ve no doubt that Mary Harney wants to privatise nursing home care in an effort to wash her hands of responsibility. Our healthcare system is already in total crisis and this imminent depletion of public nursing homes, will only further escalate the problems. It’s a ticking time bomb.


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