Documents You Might Need

When faced with a diagnosis of cancer, doctors will often recommend that a patient ensure that his or her affairs are in order. Having the proper legal documents in place is critical to ensure that you get the type of care you want and need, and to make sure that your wishes are carried out. It also helps to make the process easier on your family members. The following list outlines the documents you might need.

Durable Power of Attorney

A power of attorney is a document in which a person gives another person the legal authority to act for him or her. That person is called an “attorney in fact” or an “agent,” and the person signing the Durable Power of Attorney is called the “principal.” A person could name a spouse, adult son or daughter, relative, or trusted friend as their agent. The actions of the agent are legally considered to be the principal’s actions. The agent can be given broad power of attorney to make decisions and handle all aspects of the principal’s affairs, or limited power to act on their behalf in certain instances only.

Most people are not aware that a simple power of attorney is revoked, and the agent’s power to act as principal ends, if the principal becomes incapacitated. With a durable power of attorney, an agent may continue to act on the principal’s behalf even after the principal becomes incapacitated. If the power of attorney so provides, the agent can use the principal’s funds to pay bills, contract for hospice services for the patient’s care, and take care of other needs. An attorney can help your loved one prepare a durable power of attorney under the laws of his or her state.

A durable power of attorney for health care, also known as the health care agent or proxy, is an individual appointed by your loved one to make decisions about his or her medical care if he or she becomes unconscious or can no longer speak for himself or herself. A health care agent can be assigned as part of the advance medical directive form.

Advance Medical Directive

An advance medical directive informs a person’s physician and family members what kind of care he or she wishes to receive in the event that he or she can no longer make his or her own medical decisions. Your doctor or hospital may have a form complying with the laws of your state that you can complete.

Living Will

A living will is a type of advance medical directive that outlines what kind of medical treatment you want in certain situations. It only comes into effect if the person is diagnosed with a terminal illness and has less than six months to live, or if the person is in a persistent vegetative state. A living will does not, however, allow you to name someone to make decisions on your behalf.

Do-Not-Resuscitate Order

A do-not-resuscitate order (DNR) is a signed order directing that no cardiopulmonary resuscitative efforts (efforts to start the heart after it has stopped) are to be undertaken in the event that the person’s heart stops beating or he or she stops breathing. A DNR can be part of an advance directive.

Last Will and Testament

A last will and testament is a statement of what a person wants done with their estate after their death. It names the “executor” of the estate, or the person responsible for ensuring that these wishes are carried out and for concluding the affairs of the estate. It also names those people who are to receive the assets of the estate. If a person dies without a will that is valid under the laws of their state, their estate will be divided according to state law, typically to the spouse and/or children of the deceased.

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Community-based Support Groups

Your hospital or local United Way may be a resource for finding a support group in your area. Here are some national organizations that might also help you find a local support group:

American Cancer Society
This well-known organization’s Web site provides links to American Cancer Society support groups in locations around the country.

Anderson Network

The Anderson Network is a cancer support group of more than 1,300 current and former patients. It also offers a patient and caregiver support line at 1-800-345-6324.

Cancer Hope Network

This non-profit organization provides free and confidential one-on-one support to cancer patients and family members with trained volunteers who have themselves undergone a similar cancer experience. They can also be reached toll-free at 877-HOPENET.

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Online Support Groups

Online groups provide many of the same benefits as traditional support groups. They are particularly beneficial to those who are largely homebound or who live in a rural community, and those who might otherwise feel isolated and alone in their caregiving role. A caregiver who cannot leave home can be a contributing member of an online group at any time and in any place.
Here are some online support groups that may be helpful to you.

Mesothelioma News Forum

(IN DEVELOPMENT) This forum will be dedicated to the discussion of a variety of issues related to mesothelioma, including treatment options for the disease. It includes a special forum for caregivers of mesothelioma patients to share their experiences and support one another.

OncoChat

This online support group for cancer patients, family and friends is a place to get to know others and share your experiences and concerns.

Association of Cancer Online Resources

ACOR is a collection of online communities designed to provide accurate and timely information in a supportive environment.

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Where Can I Turn for Support?

Support groups are available to people dealing with a variety of life’s challenges. According to an article in the textbook Psychiatric Nursing, over 20% of Americans have participated in some type of self-help group. With online support groups increasing in number, the percentage is growing rapidly. Chances are good that a support group exists in your community or on-line that can help to provide you the support you need.

Support groups may provide several benefits:

• A safe, non-judgmental atmosphere for sharing feelings
• A social outlet for connecting with others facing similar situations
• A source of reliable information-sharing
• A place to learn how others have coped with challenges similar to the ones you are facing
• Support from others who understand from personal experience what you are going through
• The reassurance that you are not alone

There are many types of support groups, including groups of caregivers, groups with a focus on a particular disease such as mesothelioma, and family-centered groups.

Characteristics of a successful group may include some or all of the following:

• A caring atmosphere and trust among members
• A mix of participants
• Clear structure and purpose
• Agreement on group rules, including confidentiality
• A good facilitator

Below are some sources of support groups that may be of help to you. For more information about cancer support groups, see the National Cancer Institute’s “Cancer Support Groups: Questions and Answers.”

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Questions to Ask Your Doctor

Talking to your doctor can be difficult if you have cancer. No matter what your diagnosis, simply hearing about it can leave you feeling frightened or overwhelmed. Fortunately, there are several things you can do to make communicating with your doctor easier.

Studies have shown that clear communication between doctor and patient can help you feel better about your choices, and can even improve the quality of care you receive.

Remember that you are the consumer.

As a patient, it is important to remember that you are a consumer of health care. Just as you would not purchase a car without asking questions, neither should you be afraid to ask questions about your doctor or your treatments. The way to begin making difficult decisions about health care is to educate yourself. The following are some tips that will help you talk to your doctor:

• Bring someone with you. It may not seem necessary, but it is a good idea to bring someone with you when you have an appointment. It is always helpful to have support, a second set of ears, and another person to think of questions.
• Write out a list of questions beforehand. When you are discussing something as important as your health, it is easy to become nervous or upset. A list will help you remember important questions. Make them specific and brief because your doctor has limited time. Ask your most important questions first.
• Write down the answers you get. Writing down answers will help you remember your doctor’s responses and instructions, and will help you understand as much later as you did during the visit.
• Make sure you understand what you are saying and hearing.
• When you are talking to your doctor, use “I” statements. For example, the phrase “I don’t understand…” is much more effective than “You’re being unclear about…”
• Also, don’t be afraid to be assertive. If you don’t know what a word means, ask about it. Remember to make your questions specific and brief. If there is something you can’t understand or resolve, ask your doctor if there is some other time that you can discuss it in more detail.
• Finally, if something seems confusing to you, try to repeat it back to your doctor. For example, “You mean I should. . . .” If you think you will understand better with pictures, ask to see X-rays, slides, or have the doctor draw a diagram.

Questions That Can Help in Cancer Treatment and Follow-Up

Here are some questions that you may want to ask your doctor or nurse. They will help you begin to learn about how treatment will affect you.

• What is the recommended treatment?
• How often?
• What are the side effects?
• What are the benefits vs. the risks?
• Are there treatment choices?
• Is there anything else I should be asking?
• Is there anything I can read about this?

Sources of Information

Most doctor’s offices and treatment centers have pamphlets and brochures on cancer and cancer treatment. If not, other places you may look are centers for medical consumers, pharmacies, or health food stores. Your local library will have medical journals and reference books. You can also call CancerCare at 800-813-HOPE (4673) for informative materials on cancer related subjects.

There is an enormous amount of information about cancer on the Internet. CancerCare’s Web site (www.cancercare.org) provides links to high quality and comprehensive sources of information for all cancer diagnoses and treatment concerns. If you don’t have a computer, most libraries can help you gain access to the Internet.

CancerCare’s free publication, “A Helping Hand: The Resource Guide for People with Cancer,” features over 100 pages of regional and national nonprofit organizations that are available to assist you and your family in finding help and information to meet your specific needs. Call CancerCare at 800-813-HOPE or request a copy of the guide via e-mail at info@cancercare.org.

Besides your doctor, use your entire health care team — nurses, social workers, and medical personnel — as resources.

The most important thing to remember: Talking will help you get better care and improve the quality of your life.

Ed. Source: CancerCare

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