Uncertainty

Uncertainty is common among all of us, from those needing care to care givers to to family and friends. We all handle uncertainty differently. Some patients and family members will create a false certainty to prevent the anxiety associated with not having answers. They have a need to suppress questions such as, "What will happen to me and my family?" -or- "Will I have to live this way for the rest of my life?"  A false certainty of "curability” may allow a patient to continue the workup and therapies and to live with other unknowns. Yet false hope or denial now can produce depression when it is unmasked later on.

What can partners family and friends do for the patient believing that cure will surely occur? Listen to the patient. Ask yourself if the beliefs are helping or hurting the patient. But don’t let these beliefs lead the patient to postpone tests or therapies. Early on, patients commonly create barriers to information that runs contrary to their hopes or beliefs.  In the early stages of gaining information about a cancer, people may be dealing with too many issues, and it may be wise to let their false certainties go by, unchallenged. As time passes, there may be an opportunity to have a more truthful discussion with the patient. Alternatively, you may want to get a message to the doctor about the patient's beliefs that she or he is curable and let the physician bring the issue up at an appropriate time. There are times when a mental health consultation is helpful, as when patients also have a clear-cut depression or anxiety disorder that needs attention.

Some patients want counseling on how best to cope with the psychological problems that come with having an illness.  Yet some symptoms arising from anxiety, depression, and uncertainty are not easily related to these psychological problems. Examples are nightmares, confusion, loss of appetite, an inability to be calm, or yelling at family members and feeling helpless. As a family member or friend, the best you can do is try to get the patient professional help. Patients themselves will often recognize the issues and ask for help to understand what is happening.