Many feelings come up as people deal with illness; fear, anger, grief, and anxiety are all normal feelings for patients as well as their family. Some people let their feelings out and some hold them in. If you can recognize and acknowledge your feelings, they are less likely to cause you more anxiety as you go through this transition. The important thing is not to get stuck in any one feeling for too long.  If this happens you may want to discuss it with your doctor.

Most people find it helpful to have someone who will listen as they talk about their feelings.  Having a trusted nonjudgmental friend, family member, support group, church member, or nurse who will listen and/or give you feedback as you go through this process is very important.

Many fears may arise as people go through the transitions at the end of life.

People fear:

• Being in pain.

• Losing control over their own body, not being
  able to take care of themselves or being
  able to think clearly.

• Being a burden to their family.

• Being abandoned as they face the
  uncertainties of dying.

• Having a long lingering death.

Anger

Anger is a normal part of the process of grieving and letting go. Patients may be angry because they do not know what to expect. They may feel abandoned and scared, and not ready to die. Family members may be angry or resentful because of the demands of caregiving.  There may be a strained relationship with the patient.  Family members may be afraid, too; anger might be directed at other members of the family, the patient, caregivers, doctors, themselves, or even God. 

There are many ways to express and deal with anger. Some people pound on pillows to let out their anger. It is important to find whatever works for you. Letting others know you are angry can be a simple statement of your feelings of angry.

Some people can support you when you are angry, and others will walk away. If they walk away they are saying they cannot deal with anger, not that they don’t care.

Grief

Both patients and family members grieve a loss of control and changing relationships, roles, and life.  Patients may grieve the loss of their identity as a healthy person with a job.  Whether the illness is sudden, chronic, or like a roller coaster ride effects grief. We all grieve differently, and there is no “right” way to grieve. Grief is a slow process that has many stages, and as we grieve we go back and forth through these stages and feelings. Noted author and hospice advocate Charles A. Corr says an important component of grief is the “unfinished business” a patient may or may not want to address. It is important for the caregivers to listen to these needs and help the person address them if possible. We can all learn from those who are dying.

Depression

Fatigue

Fatigue is a major problem for cancer patients and their caregivers.  It can lead to depression and isolation for the patient and caregiver alike. 

Most cancer patients experience fatigue at some point during their illness. And this is not regular run-of-the-mill fatigue either. Cancer Related Fatigue (CRF) can be mild or debilitating or anywhere in-between. You just feel completely spent - physically and emotionally. Caregivers are at risk of fatigue also from their added responsibilities and stress. 

To read more about fatigue and steps you can take to control it, click here to go to the Fatigue article in the Managing Side Effects Center.

HELPFUL HINT FOR CAREGIVERS Sometimes people worry about things that do not make sense.  Humor is a good way to stop irrational thoughts.  Simple statements such as “horse feathers” can let a loved one know their thoughts are not realistic or likely to happen.  A good sense of humor goes a long way as you deal with all the ups and downs of being terminally ill.

Anxiety

Anxiety can be associated with depression.  Anxious people may experience restlessness, mood swings, difficulty eating and sleeping; they may hyperventilate, have trouble concentrating, and have a pounding heart. Anxiety is a normal reaction to facing death, pain, and difficulty breathing.  This anxiety usually passes as the pain or breathing problem passes. Shifting relationships, financial worries, loss of control, and health changes such as a reaction to a medication can also cause anxiety. Just like depression, anxiety can last for weeks on end. If either the cancer patient or a caregiver has symptoms of depression or anxiety or if it is unclear, people should discuss this with their doctor.

Suicide

Some people have thoughts of hastening their death. This happens when they are worried, overwhelmed, feel helpless, or are afraid.  People have different views about whether suicide is an option. However doctors, except those in Oregon, cannot legally help patients die. Tell your caregiver what you are thinking; it can help them better understand your suffering.

Written by  Linda Miller, RN, MA
Edited by Rachael Myers Lowe, cancerpage.com

This page was last edited on 04/18/2008