Caring for Seniors Undergoing Chemotherapy

Here are some suggestions offered by one woman who went through chemotherapy:

• Accompany your parent to chemotherapy
• Prepare and serve meals
• Send or bring flowers (those without strong fragrances are probably best) or a CD with an upbeat note
• Tell friends and family to call, not just at the beginning of treatment, but midway through it

Since seniors have fewer nerve cells, and those they do have are losing their coating (causing them to transmit signals less effectively), they may be more prone to chemotherapy-induced neuropathy (nerve damage) than younger people. This nerve damage usually occurs in the hands, feet, arms and legs, and it can produce:

• pain
• tingling
• numbness
• a decreased sense of touch

Here are some things you can do to help:

• Encourage your parent to walk if it is not too painful, as this might increase blood circulation and reduce the neuropathy.
• Caution your parent to avoid using sharp objects, such as razor blades, knives and scissors, as due to the neuropathy your parent may not perceive he or she is getting cut until it is serious. An electric shaver would be safer at this time.
• Check that your parent's finger and toe nails are not sharp or too long, so that your parent won't inadvertently scratch him- or herself with them.
• Avoid keeping the temperature in your parent's home very warm or cold, as either extreme could be painful.
• Purchase shirts that don't need to be buttoned, shoes that don't need to be tied, and pants that don't need to be fastened. These will make your parent's life easier and help him or her to be more independent.

You can talk with your parent about the various relaxation techniques available and encourage him or her to try one on a regular basis. Many cancer patients have found these techniques enormously helpful in reducing stress and gaining a sense of some control over their bodies, as they achieve a relaxation response. Relaxation techniques have also been shown to help cancer patients to sleep better -- which for many is an important issue.

If your parent is traumatized by hair loss:

• Empathize, and don't minimize. Even though this symptom is not as debilitating as, say, nausea, it is very public and distressing. Don't rush your parent into thinking about wigs and hats. Let him or her focus as long as needed on the unwished for change.
• When your parent is ready, accompany your parent to find wigs, hats, eyebrows and/or eyelashes that will help your parent feel more comfortable with him- or herself again. Support your parent's search for the right look. The hair loss may reinforce your parent's sense of loss of control due to aging in general, and feeling okay about appearance can help your parent feel more in control. Some websites that may be helpful are: Headcovers Unlimited and breastcancer.org.
• If your parent expresses shame or discomfort for being upset about something superficial like appearance, let him or her know that the reaction is totally understandable.
• If your parent is reluctant to be seen in public with this evidence of illness, help him or her come up with a response to use if someone comments on it.
• If your parent is depressed due to the hair loss, find someone your parent can talk to who has experienced the same thing, and see if this helps. Some people, if they can summon the energy to do so, find that exercise improves their sense of well-being, which helps their mood and therefore helps combat depression. If this doesn't help, find a professional to treat your parent's depression.
• Suggest, but don't insist, that your parent join a cancer support group, which many patients find helpful. Some support groups share their experiences and feelings, while others participate in activities like yoga or guided meditation. Support groups can be found at your local hospital, or online at cancer.org. Find one that fits your parent's personality and preferences.
• Many people find talking with a clergy person to be helpful.

Nausea is one of the more unpleasant effects of chemotherapy. Whatever you can do to help minimize the nausea will make a significant difference, as nausea is the main reason people stop chemotherapy. Here are several ways you can help:

• Encourage your parent to try a light meal a few hours before chemotherapy, which some have found to help stave off nausea.
• Eliminate all smells in your parent's home, such as from food (especially fish), garbage, or even car exhaust, any of which could provoke nausea.
• Offer your parent many small, easy-to nibble portions of food throughout the day.
• Keep snacks, such as nuts, crackers, or dried fruit, by your parent's bed, as eating a little bit before getting up helps counteract nausea.
• Suggest that your parent rest after a meal in order to hasten digestion, which will help lessen nausea.
• If possible, encourage your parent to eat outside, in the fresh air. Fresh air will help counteract nausea.
• Offer your parent liquids -- especially water, flat ginger ale, cold mint or ginger tea -- which help prevent nausea.
• Suggest that your parent suck lemon drops, peppermint or ginger candy, which helps prevent a dry, sour taste which can trigger nausea.
• Find something for your parent to focus on after meals -- such as a video, board game, TV show or cards -- to take his or her mind off of nausea and help prevent it.

Some people find them very helpful. You can:

• Encourage your parent to relax before treatment. Many people find the regular practice of relaxation techniques to be very helpful at this time, reducing fatigue and improving sleep.
• Listening to calming music, meditating, reading or enjoying a hobby, can all decrease nausea.
• Suggest that your parent try acupuncture, which some people find helpful in counteracting nausea.

Mouth sores can develop when the chemotherapy targets fast-growing cells, which are also found in your mouth, throat and lips. To cope with mouth sores, you, a friend or home care aide can:

• Prepare soft, moist and easy-to-chew foods such as cooked cereal, mashed potatoes, eggs, cottage cheese, pureed soups or baby food. Other sweeter options include ice cream, pudding, yogurt, milkshakes, smoothies, Jello, bananas, applesauce, and custards.
• Puree cooked foods in a blender to make them easier to eat. Take care to wash all blender parts -- ideally in a dishwasher -- before and after use to avoid infection.
• Offer food in very small, bite-size portions, and always accompany it with something to drink.
• Soften food with gravy, sauces, broth, yogurt, etc.
• Serve foods at room temperature or cooler, as warmer foods may be painful as they go through the mouth and throat.
• Offer your parent ice chips or popsicles to suck on throughout the day, as they can help relieve mouth pain.

As a result of aging, seniors experience chemotherapy differently than younger people. A prime reason for this is that as they age their kidney function decreases, making the kidneys less able to cleanse the toxic chemotherapy drugs from their systems. So, the drugs build up in their bodies to more dangerous levels, often resulting in more side effects, such as exhaustion, nausea, and others. Also, treatment and recovery are complicated due to the frequent existence of other diseases.

Since your parent is undergoing chemotherapy for his cancer, he should be aware that smoking can inhibit the effectiveness of some chemotherapies, and can also increase the number of side effects from the treatment. All in all, stopping smoking will improve the effectiveness of the treatment, his sense of well-being, and eliminate a possible cause of further cancers.

Here are some helpful responses:

• Offer emotional support
• Listen with compassion, without judging
• If your parent is concerned that his or her remaining quality of life will be poor, validate those concerns, but let your parent know that together you'll make the most of the remaining time, that you'll be there with him or her. This will be especially necessary if your parent has experienced loss of a support system -- perhaps due to death or a move.
• Offer hope
• Talk with your parent's doctor about the possibility that the depression was induced by medication.
• Help your parent get professional treatment for the depression.
• If your parent has enough energy, encourage him or her to do some exercise, which helps lift a person's spirits.
• Suggest, but don't insist, that your parent join a cancer support group, which many patients find helpful. Some support groups share their experiences and feelings, while others engage in activities like yoga or guided meditation. Support groups can be found at your local hospital or the American Cancer Society. Find one that fits your parent's personality and preferences. For those who have neuropathy, there is a specific support group at neuropathy.org.
• Many people find that talking with a clergy person is helpful.

Care.com is a website that lists people throughout the United States who provide care to seniors, includes photos and descriptions of their experience, and does free background checks for members. You can search by zip code. For specific listings, go to: Care.com.