Coping as a carer Caring for a loved one who's terminally ill can be very distressing for friends and family members. In spite of the challenges which lie ahead, there are a number of ways you can learn to care more effectively, says Dr Ros Taylor.

In this article

The challenges

Practical help

Listening and laughing

Life changes permanently for everyone in the family after a serious diagnosis. Roles change, dynamics change, it's easy to let tensions build up and, before you know it, you may have a tense situation. The upheaval that illness brings needs to be acknowledged and discussed, otherwise feelings become overwhelming and relationships are put at risk.

Families and friends of patients often say that they don't know how to act. They don't have to 'act' - they just have to be themselves. Life has changed, but there can still be plans, goals, achievements and fun.

There are several ways you can help but you must look after yourself too. Everyone finds their strength, compassion and resilience in a crisis, but eventually it may wear you down. It's important to recognise your own limitations and be kind to yourself, as well as the person you're caring for.

Offering to help with practical tasks is valuable

It's often important to try to keep things normal. Offering to help with practical tasks is valuable. Let the patient know what you can do specifically - for example, the ironing, the shopping or picking up the children. Don't just say you'll do 'anything', as the patient is unlikely to take up such a vague offer.

On the other hand, you may feel compelled to do too much, which may reinforce your patient's feelings of helplessness and hopelessness. Even if someone can't do something, they can think and be involved in decisions and discussions. Don't assume that your patient is mentally frail as well as physically frail. Include, consult and involve those you're caring for in all you do.

These are two skills which you can easily offer.

Listening to someone's fears, worries and sadness without offering advice or solutions is hard, but one of the most helpful things you can do. Stay with them, offer encouragement to continue, and try to feel at ease with gaps in the conversation. You don't need to give answers, suggestions or solutions. Don't change the subject. Say if you feel uncomfortable with what's being discussed. Share your sadness or distress: it'll bring you closer.

Humour is an important stress reliever. It may seem out of place when life-threatening illnesses are being discussed, but it's a great coping mechanism. A balance of laughter and tears is the key.