 Hello everyone and welcome to the caregiver quandary. What role do they play? You just found out that your husband, wife, mother, father, significant other or close friend has just been diagnosed with cancer. Six letters that you never wanted to hear for anyone that you love or care about. And that's flowing through your head, cancer, cancer. I remember when I got it, Sharon Lee Parker, you have cancer. It's in the world of the unknown to man and yet confronts us like an unwanted, belligerent guest. You know you will be a part of the process but how important are you? Whether you're the patient or you're the caregiver. The thoughts that run through the caregiver's lines are many and change the dynamics of the one who has the cancer and the one who suddenly has an additional role in life. What do I do? Who shall I tell? Why did it come? Should I keep quiet? Who do I trust? Is this really happening to us? Where do I go for help? How do I begin to cope? How much will it cost? Will insurance cover all of this? What about the mortgage and the children's college and the tuition? How do we survive? These are just some of the questions that swirl around through many a caregiver's head if they are the primary caregiver and often unpaid. How do we help them overcome the fear and educate them as well to become a part of our healing team? The way we incorporate these valuable members of the cancer patient's inner circle impacts our reputation and the word on the street about this complex center, which to a new visitor may seem overwhelming and so confusing. The location of our CATS gaps, the MRIs in a different building and an emergency room that's not here, but a block away often seems overwhelming and can cause great consternation in the head of the caregiver. Even the parking and obtaining a wheelchair can be confusing and disorienting when emotions are already higher than normal. Hundreds of thousands of dollars are spent each year to promote and publicize our beautiful facility as we strive to be a cut above and better than the competition. Helping the caregivers and their families cope with education and emotional support is key and we are ready for the task and hand by incorporating all of our staff into the unique culture of the JTCC, which shouts out, we care and we'll do whatever we can to make this journey for everyone involved as positive and comfortable as possible. You bet we will. When we look at the poster for the Life in Liberty celebration, what do we see? Thousands of people who are associated with our cancer centers smiling and promoting by their acceptance of how we deal with cancer for their world to know about and we've been blessed so far to do it for 10 years. They in fact are the walking billboards for the JTCC. They are worth more than gold in the public arena because they are more than words on a billboard. They are the billboard and we can't wait to do it again. Emotions can run wild because a cancer patient is the one person whose emotions can really surface with anger, frustration, a feeling of helplessness and the unknown, how well I know because I had it 20 years ago. But look at me now, when the right doctors come along and save your life with a fabulous staff, you know that you can make a difference in other people's lives and make it better for everyone around you. But at the time the future can seem dim or bleak and we often send in the troops to raise the spirit and the outlook. But what about the caregiver, the husband, the wife, parent, child or significant other who is taking the brunt of everything while trying to encourage and care for the patient at home, we need to look at this carefully for any sign of deterioration. We need to find out how they are doing as well because if they are failing or full of hopelessness or despair, our patient could suffer. Caregivers often hide what might be going on at home for fear of reprisal or recrimination. And they know it falls on their shoulders to help make good decisions for their loved one. But the way a patient acts in the cancer center and the way they are at home can be two very different stories and we need to remember this. Including caregivers in helpful sessions and encouraging them to share feelings often helps a person feel that they are not alone. Putting a smile on the caregiver helps the patient as well. It is often an exhausting task for many who had no idea about cancer and never expected it to arrive at their front door. You bet it is often a shock. Faces, who are these caregivers? They could be your sister or mine. Perhaps your neighbor next door. Maybe it's even your father taking care of your mother. Think about it. It could be any of us. Do we have a responsibility to include the caregiver as an important part of the healing teams? The answer is a resounding yes. Yes on so many levels. All of a sudden a cancer diagnosis for a loved one puts a different spin on family life. Caregivers at home are more often than not educated about what is going to be a new responsibility. How do they cope? What should they do? How do you become educated about cancer? How do you become educated about cancer? The answers are varied and complex and our first allegiance is always to our patients but the extended family or friend who has this new unwanted responsibility needs to be helped and encouraged along the way so that they can be a beneficial plus to our patients outside of the cancer center. We know that optimism versus pessimism is a much better outlook for patients. Sometimes it can be overwhelming as you watch your loved one suffer with indignities like vomit, nausea or diarrhea, sharing a few moments with the caregiver and including them in the conversations we have with the patients is a plus unless of course the patient feels otherwise. How can everyone cope so that whatever the issue they are prepared to handle it in a clear heading way without making the patient feel less than the fine human being that they are. Since we know that cancer treatment often has side effects it is necessary to let our patients know what they might experience. The key however is to also focus on how to cope with any side effects. Caregivers need to know that it is normal to experience side effects and what to do to ameliorate the situation is key. It is also important to have them call the on-call nurse if things are getting out of control. Next time you are with your patients look at the faces of the caregiver. What is the demeanor? Are there frowns or smiles when they come into the exam room? Do they have questions? We need to make the time to answer questions and to ask each person involved in the care how they are feeling and ways to help them better cope with any situation. According to a recent study pain, fatigue and emotional distress are three areas that patients do not feel are being adequately addressed and we can certainly improve upon that. We need to add the patient caregivers at home to our teams of healing so they are more knowledgeable about what to do or try to help a patient in every way possible. They also need to be educated about when to call for additional support whether it be the doctor or the on-call nurse. Emotional support is key for everyone going through any upheaval and we need to utilize our nutritionists and our experts in helping patients and family members feel better. Consider the body language of the caregivers and look at their faces. Do they seem confident? Do they look a scant or intent on what you are saying? What can we do to help improve outcomes and reduce the feeling of, I don't know about what to do or home to call? Even when caregivers look confident, there are often tears and sadness that can become all-consuming. It is a fight to stay focused with some being the major wage earner and with more bills to pay and children to feed. This additional burden while not accepted often lays a heavy load on the caregiver who feels alone when they leave the cancer center and sometimes gives up with huge guilt. We can often stop that from happening. If we can educate them and include them in ways to make our patients feel better, the situation can improve. Ideas that we take for granted, they may have never thought of. Making everyone surrounding our patients proactive is key and we need to address this every time we meet. If we look for signs or symptoms of being overwhelmed or a feeling of helplessness as a caregiver watches their loved one go through the often rough road of cancer treatment, we can step in and offer advice counseling and better ways to cope for everyone involved. Yoga, nutrition and psychological support is key. Asking the question, what can we do to help you is a great question. Sometimes caregivers feel embarrassed for not knowing what to ask or whom to ask. We need to take that stigma away. Others don't feel they are educated enough to handle the at home duties and we need to know this as well. In addition, especially when it comes to nutrition guidelines, we need to break it down and simple easy to use steps and advice too so that both the patient and the caregiver can look forward to the new and often exciting ways they can eat and still feel good inside. The House of Hope by Sharon Lee Parker. Don't forget to say I love you. Don't forget to say I care. Don't forget to say tomorrow, we will have so much to share. And by the way, in case you missed it, thank you all for being there. Doctors, nurses, healing teams, and of course caregivers all deserve our love and gratitude because they hear our call. Even when days are stormy and the clouds consume the sky, remember the words hope and love, fill the world for you and I. So give a hug and share your smile and let our people know that every time they save a life, the world is all a glow. Healthy, well and on your way is what we wanna hear and to share a great big secret, every one of you is dear. So remember folks that in our world, you never stand alone. The JTCC is on your side by car, by plane, by phone. The People's House, the House of Hope with windows to the sky, filled with brains and forward thinkers who love life and wanna try to give us one that's cancer free so we can spend our day in making this world a better place. So everyone can say, I love my life and all it brings, the moon, the stars, the sun and thank you all for being here. You are the special ones. Thank you.