Cancer Care (Nursing and Health Survival Guides), 1e

Caring for people with cancer

Caring for people with cancer is multifaceted. The nurse should:

• be knowledgeable using an evidence base

• be caring, kind and compassionate

• provide physical and psychological support for the person and if appropriate their family

Previous sections have discussed the various types of treatment that may be offered, often in combination. A diagnosis of cancer and subsequent treatment regimens can have a significant impact on a person’s (and their family’s) physical and psychological wellbeing. Clear precise information is needed to help people make decisions.

At different stages of the disease the person may require different types of support, for example:

• psychological support when first diagnosed

• subsequently, physical support may be needed when the person is undergoing the various invasive and non-invasive investigations and tests

Understanding the various tests, the reasons why they are being performed and the meanings attributed to the outcomes can help the nurse help the patient.

Patient centred care means that any treatment and care offered should always take into account the needs and preferences of the person being cared for. People with cancer should be given the opportunity to make informed decisions about care and treatment; this should be done in partnership with their healthcare professionals.

• Good communication between healthcare professionals and people with cancer is essential. This should be supported by evidence-based written information adapted to the person’s individual needs.

• Treatment and care, along with the information people are given about it, should be culturally appropriate.

• It should also be accessible to those people who may have additional needs such as physical, sensory or learning disabilities and to those who do not speak or read English.

If the person is in agreement, families and carers should be given the opportunity to be involved in decisions about treatment and care. Families and carers will also need to be given the information and support that they need to cope with a diagnosis and treatment associated with cancer.

Each person is unique and their cancer is unique to them. Care should reflect the needs of the person and be tailored to encompass their cancer type. Below, make a list of the appropriate resources that you might make use of to care for the person with cancer.

CANCER TYPE

RESOURCE

DESCRIPTION OF RESOURCE

NOTES

Cervix

     

Prostate

     

Leukaemia

     

Breast (male)

     

Breast (female)

     

Brain

     

Images PALLIATIVE CARE AND END OF LIFE CARE

Not all cancers are curable. Those facing life-threatening illness such as cancer will need some form of supportive care in addition to treatment for their illness. Palliative care is an aspect of supportive care. The management of pain and any other symptoms along with the provision of psychological, social and spiritual support is essential. The aims of palliative care are to:

• affirm life and view dying as a normal process

• offer relief from pain and any other distressing symptoms

• combine the psychological and spiritual aspects of patient care

• provide a support system helping people live as actively as possible until their death

• offer a support network helping the family cope during the patient’s illness and in their own bereavement

There are two distinct categories of health and social care professionals who provide palliative care:

• those delivering the day-to-day care in homes and in hospitals

• those who specialise in palliative care, for example, clinical nurse specialists in palliative care

Those providing day-to-day care can:

• assess the care needs of each patient and their families incorporating physical, psychological, social, spiritual and information needs

• meet those needs, while being aware of the limits of their knowledge, skills, and competence in palliative care

• know when to seek advice from others or refer to other specialist palliative care services

A number of specialist palliative care services are available and are provided by expert multidisciplinary palliative care teams, who:

• carry out assessment

• provide advice and care for patients and families in all care settings

• provide specialist in-patient facilities in hospices or hospitals for those who would benefit from on-going support and care

• co-ordinate home support for patients with complex needs who would prefer to stay at home to die

Day care facilities are also available, offering a variety of opportunities for the assessment and review of patients’ needs and facilitating the provision of physical, psychological and social interventions. Specialist teams providing palliative care include:

• palliative medicine consultants

• palliative care nurse specialists

• physiotherapists

• occupational therapists

• dieticians

• pharmacists

• social workers

• those able to give spiritual and psychological support

End of life care is closely associated with palliative care:

• offering support for people who are approaching death

• helping them to live as well as possible until they die

• helping them to die with dignity

This also includes support for their family or carers.

Palliative care aims to:

• help make people as comfortable as possible

• relieve pain and other distressing symptoms

• provide psychological, social and spiritual support

• care for the whole person as opposed to just one aspect of their care

End of life care also covers legal issues, such as creating a lasting power of attorney so that a person or people can make decisions about the patient’s care if they are no longer able to do so.

Palliative care teams usually co-ordinate all services. Patients have the right to choose where they want to receive care and where they want to die. End of life care can be provided to patients and their families in hospitals, care homes, hospices and in their own home. End of life care can last for a few days only, or it may last for months or years.

Images SECTION SUMMARY

Not all cancers can be cured. The reaction to a cancer diagnosis is unique for each person and how people react is variable. Some people go through some recognised stages of grief and this can include the nurse, patient and their family.

Symptom control is the chief objective of palliative care, end of life care (closely associated with palliative care) respects the person’s choices: this may include where it is they wish to die. End of life care can last for a few days or for months or years.

Grief affects people in different ways: many people have experienced grief, but it is unique to each person. People often find it difficult to define or explain the feelings they are experiencing when they are grieving.

Think of a time when you have lost something, your wallet or purse, for example, how did you feel? Did you think:

• ‘I don’t believe this, this is not happening to me’

• ‘Why me, why is this happening to me?’

• ‘If only I could find it, I promise I will be a better a person’

• ‘Well it’s gone’

• ‘What will be will be’

Similar feelings to those above are well documented when people have had a close relative or a loved one die, they are the stages of grieving. Sometimes those diagnosed with cancer also go through the grieving process:

• ‘I don’t believe you – you have the diagnosis wrong’ (denial)

• ‘Why me, why not some nasty person, why me I am a good person, there are worse people than me in the world’ (anger)

• ‘If I am cured, if God cures me I promise I will devote my life to doing good for others’ (bargaining)

• ‘Do what you have to do I don’t care anymore – I have no interest’ (depression)

• ‘There is nothing I can do about this so I will live what I have left of my life to the full’ (acceptance)

Not all people go through all stages nor do they go through the stages in the order presented.



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