Wednesday 24th June 2015
Mac Voice, the magazine for Macmillan professionals: Summer 2015
Belinda Bentick shares her experiences of communicating with people towards the end of life
As a Macmillan nurse/psychotherapist, I support people who have been diagnosed with advanced cancer. One of the biggest difficulties that people may undergo at this time is a lack of communication. This problem can occur with medical staff, as well as with families and friends.
Encouraging people to explore their fears and develop coping strategies can reduce spirals of negative emotions. Communicating these feelings is the most important step in accepting and dealing with them.
People may often have huge and understandable anxiety about how the details of their illness are communicated. Some feel their consultation time is too short or that there is neither the time, nor the place, for them to process the devastating news. As well as dealing with their own discomforts, people also report a need to deal with staff discomfort at having to give bad news.
As professionals, keeping these worries in mind can help us take steps to address them, by adjusting our approach to conversations and ensuring that environments are as comfortable as possible. Being openly supportive and encouraging truthful conversation can break down the barrier of anxiety that can inhibit communication. Passing no judgment and wholly listening to the person allows for a willingness to open up.
One should never equate physical incapacity with mental incapacity; people with advanced cancer do not want to be treated any differently than how they were before diagnosis.
The role of family and friends
There are many support systems available at the hospital, but the role of family and friends is crucial. Talking about emotions to loved ones is invaluable. However, even with those closest, it’s not always easy to speak candidly. For people with cancer, this isolation from those closest to them can create further anxiety and lead to feelings of guilt.
Relatives and loved ones can help in a number of ways, by listening and being supportive. It is however, important that loved ones do not overlook their own needs, for this can lead to friction, which itself can shut down communication.
People with cancer, their carers and their families can refer themselves for counselling, or ask a professional to refer them.
I am very fortunate to work in a centre that has been designed especially for people diagnosed with cancer. The Hamar Help and Support Centre is located at the Royal Shrewsbury Hospital. It provides a caring and supportive service for people with cancer, their relatives and carers living in Shropshire and Mid-Wales. At the end of their sessions, many people we support seem to have connected with their inner-strength and found a peaceful way of coping.
Macmillan and Marie Curie produce a booklet, End of life: a guide, which includes information to help people come to terms with their feelings and suggests what may help. You can order copies free from be.Macmillan.
Harmar Help and Support Centre, Shrewsbury