Impact on your family and how to deal with this

Sharing your wishes will help your entire support team to care for you in the best possible way, with the greatest amount of comfort and dignity in the last weeks or months of your life. However your loved ones may well be struggling to cope with the prognosis and the prospect of having to let you go, so now is the time to lean on your specialists to assist you in helping them to deal with this.

End of life care is support and medical care when you are in the last weeks or months of your life, explains Radiation Oncologist Dr Yastira Ramdas. "It should assist you to live as well as possible until you die and to allow you to die with dignity, with the emphasis placed on quality of life for you and your loved ones while ensuring you are comfortable at every stage".

Whether you are a spouse, partner, parent or grandparent, there will naturally be a number of issues and things you need to discuss or say to your family, and these conversations are often not easy. You may want to rope in your doctor, social worker or counsellor to assist you with this or you may choose to simply go it alone, but remember that you may need support in handling their reaction when it comes to telling your children (tantrums, acting out, behavioural problems and complete withdrawal especially in older children), which is why professional help is recommended here, says Professor Carol Ann Benn, a surgeon with a special interest in breast cancer. "Everyone is going to react differently to the news and the best way to enable them to support you at this difficult time is through open communication. This involves both verbalising and listening- and not just with your ears- but also by 'listening' to body language and other emotional cues."

How to talk to your family

Just as it was important to discuss your illness with your family when you were first diagnosed, continues Prof. Benn, "It's essential to share with them the fact that you are terminally ill. Children have a knack of picking up when something is wrong, and there's no way you can protect them from this regardless of how old they may be. They also seem to be less anxious when they know what is going on. Break the news in a gentle age-appropriate way to enable them to try to process and understand what is happening. Empower them by letting them know that nothing has changed- that you're still and will always be their mom/dad/gran- and what they can do to help: whether it's a hug or cuddle that you need or just their presence at your side. Make sure structures are in place to enable them to be heard and that teachers and schools know about the situation. Hopefully this will give also give you some form of closure and some peace of mind."

Prof. Benn and The National Institute of Cancer offer the following tips on how to break the news to your family.

Young children

• Use simple language and the right words to ensure that they understand
• Always be honest and answer their questions no matter how difficult they may be
• Reassure them that what's happening to you is not their fault
• Encourage them to verbalise how they are feeling
• Reaffirm your love for them and the fact that they will always be looked after and loved.

Living mindfully

Caregivers faced with the physical, emotional and financial stress of caring for a cancer patient are at a high risk of developing anxiety and depression. Mindfulness, the state of focusing your awareness on the present, has taken the world by storm, with its reported benefits including an increased feeling of calm, clarity and well-being, as well as the alleviation of pain and insomnia. Mindfulness-based apps can monitor your mood and stress levels, send you daily inspirational messages and offer short guided meditation videos and relaxation techniques that may benefit both you and your patient.

Teenagers

Teenagers may either act out or withdraw so give them both the space and the time to deal with the news. If you're battling to communicate with your teen, get a therapist involved asap.

Your partner or spouse

It's vital that your partner or spouse is well aware of all your wishes. If you find it difficult to communicate when it's just the two of you alone, rather do so in the presence of a professional.

Try to be as mindful as possible about the way he or she may be feeling and how much responsibility can be realistically placed on his or her shoulders going forward. Again open communication is essential right now, as is both of you being heard.