Welcome to the COVID-19 and Cancer ECHO Series

Use the Q&A portal throughout today’s session to submit your questions! Our expert faculty will be
answering your questions live.

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This ECHO will be recorded.

INTRODUCTIONS

Facilitator

Erin Kent, PhD, MS

Associate Professor
University of North Carolina at Chapel Hill
AMERICAN CANCER SOCIETY COVID-19 AND CANCER ECHO

Today’s agenda

Introductions Erin Kent, PhD, MS

5 minutes

Didactic presentations Rachel Cannady

J. Nicholas Dionne-Odom, PhD, APRN,
ACHPN, FPCN
20 minutes

Question and answer Expert faculty panel

session 25 minutes

Wrap-up Richard Killewald, MNM

3 minutes
Introductions
AMERICAN CANCER SOCIETY
INTRODUCTIONS

Expert faculty panel

Durado Brooks, MD, MPH Rachel Cannady J. Nicholas Dionne-Odom, Matthew Loscalzo, L.C.S.W.,
Vice President, Prevention and Strategic Director, Cancer Caregiver PhD, APRN, ACHPN, FPCN APOS Fellow
Early Detection Support Assistant Professor, School of Nursing, Liliane Elkins Professor in Supportive Care
American Cancer Society American Cancer Society University of Alabama at Birmingham Programs (NPI 1437690500)
Co-Director, Caregiver and Bereavement City of Hope
Support Services, UAB Center for
Palliative and Supportive Care
Didactic presentation
AMERICAN CANCER SOCIETY
DIDACTIC PRESENTATION

Today’s presenter

Rachel Cannady
Strategic Director, Cancer Caregiver Support
American Cancer Society
DIDACTIC PRESENTATION

Impact of Caregiving During COVID-19

▶ Cancer impacts the entire family, including close friends

• Emotional distress (especially guilt), physical demands, activity restrictions
• Altered job responsibilities and financial hardships
Caregiver ▶ Most stressed caregiver is female, employed, caring for children and a
cancer patient simultaneously
Profile
▶ Positive effects
• Post-traumatic growth/benefit-finding
• Improved self-esteem and self-worth/satisfaction with life
DIDACTIC PRESENTATION

Myriad of Caregiver Experiences

Psychosocial
Distress

Work and Lost in the

financial healthcare
concerns system

Lack of
Fear of
medical
Recurrence
training

Poor
Social
Physical
Isolation
Health
DIDACTIC PRESENTATION

Caregiving and COVID-19

• Caring for someone with cancer has become even more serious
because of the coronavirus pandemic.

• People with lymphomas, multiple myeloma, and most types of

leukemia are at the highest risk for infections. These cancers
cause changes that make the immune system unable to work as
well as it should. ALL cancer patients are immuno-compromised.

• Follow all guidelines from the CDC to avoid the spread of germs.
Don’t Forget…
• Take a break each day to recharge and refresh
• Make sure you’re exercising each day – it’s as simple as a walk
around the block or doing a 30-minute online class
• Make sleep a priority (at least 7-9 hours per CDC)
DIDACTIC PRESENTATION

Impact of Caregiving During COVID-19

DIDACTIC PRESENTATION

Caregiving and Social Distancing

Food Prep Rides to Treatment Point of Contact

Contact-free delivery; small If you’re the patient’s only ride If applicable, become the
portions; include plastic to medical appointments, make patient’s point of contact for
cutlery and straws; gift cards sure to fully sterilize the car medical appointments to help
to favorite restaurants before and after coordinate care

Connection Self-Care Stay Healthy

Regular video calls with Recharge daily; healthy Following the CDC Guidelines
family and friends; watch the nutrition and regular on how to prevent the spread of
same movie together; play exercise; online caregiver the virus will keep you healthy
online games together support groups; GET OUTSIDE and will protect the patient
DIDACTIC PRESENTATION

Caregiver Resource Guide

DIDACTIC PRESENTATION

Caregiver Resource Guide: cancer.org/caregiverguide

Cancer Caregiving Cancer Treatment

Caregiver Self-Care Patient Nutrition

Communication Coping

Cancer Information Caregiver Resources

Online, interactive Guide

Free copy at 1-800-227-2345
DIDACTIC PRESENTATION

Caregiver Support Video Series: cancer.org/caregivervideos

CAREGIVER PHYSICAL CARE ADVOCACY

SELF-CARE TRAINING • How to effectively
• Healthy Eating • Drain Care communicate the
patient’s needs to the
• Physical Activity • Pain Management
cancer care team
• Stress Management • Management of Side
• Fear of Recurrence Effects
• Relaxation • Medication
Management
• Signs of Infection
• Lifting
DIDACTIC PRESENTATION

Today’s presenter

J. Nicholas Dionne-Odom, PhD, APRN, ACHPN, FPCN

Assistant Professor, School of Nursing
University of Alabama at Birmingham
Co-Director, Caregiver and Bereavement Support Services, UAB
Center for Palliative and Supportive Care
COPING WITH STRESS
WHILE SUPPORTING
SOMEONE WITH
CANCER

J. Nicholas Dionne-Odom, PhD, RN, ACHPN

Assistant Professor | UAB School of Nursing
Co-Director | Caregiver and Bereavement Support Services
UAB Center for Palliative and Supportive Care
Email: dionneod@uab.edu
Twitter: @N_DionneOdomPhD
 Common challenges faced by families
Meds/Symptoms
Relative with serious illness
Domestic Spouse/partner
Finances
Personal care
Practical Social Children
Transportation MD visits MDs/other
Other family and
healthcare
friends
Getting help professionals
Locations of care Managing one’s
own health
Decisional Sleep Physical conditions
Self-care
End of life
Medications Time for
Diet Physical activity
enjoyable
Guilt Sadness Loss or crisis of
Loneliness activities
faith, purpose,
Emotional Overwhelmed Spiritual and Religious and/or meaning in
life
Resentment Anxiousness Isolation from
Trouble relating to
Uncertainty faith community Loss of time for
Feeling God
unappreciated spiritual practices
 How does stress work?

Thoughts
Stressor Behaviors Physical
&
& Habits Symptoms
Feelings

Juggling work & home “I can’t cope!” Forgetting things Feeling tired all the time

Providing transportation “How are we going to pay for this!” Ignoring or avoiding problems Can’t sleep
Bad temper Headaches
Watching a relative “Ugh!! I didn’t sign up for this!”
struggle with symptoms Avoiding friends Change in appetite
Worry, anxiousness, sadness,
Pain
Talking with your loved anger, guilt, frustration, fear Missing medical appts.
Upset stomach
one about the future
Drinking or smoking more Difficulty concentrating
Eating poorly Lower sex drive
 Ways to cope with stress

AVOID unnecessary stress

ALTER the situation
ADAPT to the stressor
ACCEPT the things you cannot change
 AVOID unnecessary stress

Learn to say “no”

Avoid people who stress you out
Take control of your environment
Shorten your to-do list
 ALTER the situation

Talk about how you’re feeling instead of

bottling them up
Create a balanced schedule

Leverage assistance and other resources

 ADAPT to the stressor

Reframe problems

Adjust your standards

Practice gratitude
ACCEPT the things you cannot change

Don’t try to control the uncontrollable

Look for the upside; consider challenges
growth opportunities
Learn to forgive
Share your feelings
Getting and Asking for Help…3 options
for getting tasks done

1 Do the job yourself

2 Coordinate family
or other volunteers
3 Hire outside help
 10 beliefs that prevent families from asking for help
1) If I request help, my family will view me as selfish and uncommitted
2) Meeting all the needs of my loved one is my duty. No one can do as good a job or get it “right”
3) The person I’m caring for refuses help, guilt trips me or insists that I do everything
4) I guilt trip myself. I’ll feel bad or like a weak person if I don’t do it all.
5) No one else has stepped up.
6) Hiring help is too expensive. (It may be the case, but have you really explored the options?)
7) I don’t want to burden others with these problems.
8) I don’t know how or where to get help—or how to ask for it
9) No time, too busy to think about it.
10) I don’t trust outside help (“strangers”). How do I know what they’re doing when I’m not there?
 Option 1: Do the job yourself

Prioritize your time and responsibilities

Explore employer benefits

Learn caregiving skills

Option 2: Get help from friends/family
Most family/friends appreciate the opportunity to be
helpful

Step 1: Get clear on what you want help with

Step 2: Identify and make a list of who could help

Step 3: Coordinate the support

 Option 3: Pay for help
Caregiver services in the community (e.g., American Cancer
Society, Area Agency on Aging)
Family member affiliations (e.g., fraternal
organizations)
Community transportation services
Adult day care
Personal care services
Health care services (check with your insurance company)
Meal programs
 Having trouble deciding whether to delegate a task?
Think of a job or task that needs to be accomplished on a
regular basis. Ask yourself:
To what extent could I let this task go?
4 - Essential: it is something that has to be done
How valuable is this task to helping my loved
immediately
one have the best quality of life possible?
3 - Important: it’s not urgent but has to be done soon
4 - It is essential and must be done.
2 - Discretionary: is something that can be done if there
3 - It helps in a small way.
is time
2 - It has no impact, positive or negative.
1 - Unimportant/Optional: this could be cut immediately
1 - It has a negative impact.
10 or lower? Consider delegating.
To what extent could someone else do it on my
How much personal value do I get from doing it?
behalf?
5 - Definitely keep: It’s one of the best parts of
5 - Only I can handle this
supporting my loved one.
4 - This task is best done by me
4 - Probably keep: I enjoy this activity.
3 - If structured properly, this task could be handled by
3 - Not sure: This task has good and bad points.
someone else
2 - Probably drop: I find this task or activity tiresome
2 - This task could easily be done by someone else
1 - Definitely drop: I dislike doing it.
1 - This task could be dropped altogether
Adapted from the Sept. 2013 Harvard Business Review article “Make Time for the Work that Matters”
 Thank you!

J. Nicholas Dionne-Odom, PhD, RN, ACHPN

Assistant Professor
School of Nursing
University of Alabama at Birmingham
Email: dionneod@uab.edu | Twitter: @N_DionneOdomPhD
Question and answer session
Use the Q&A portal to submit your questions
AMERICAN CANCER SOCIETY
QUESTION AND ANSWER SESSION

Question 1

What precautions should caregivers take to

limit COVID-19 exposure?
QUESTION AND ANSWER SESSION

Question 2

What tips do you have to provide hope and

motivation to a loved one with cancer during
and after treatment?
QUESTION AND ANSWER SESSION

Question 3

What activities are safe if a parent is undergoing

chemotherapy during COVID? Can kids play
sports and go to in person school?
QUESTION AND ANSWER SESSION

Question 4

How do you convince your family you need

help?
QUESTION AND ANSWER SESSION

Question 5

What materials do you have available for

depression and coping with cancer during this
pandemic (English and Spanish)?
QUESTION AND ANSWER SESSION

Question 6

What role do medical oncologists, surgical

oncologists, have in promoting contact tracing
in the COVID 19 pandemic ?
QUESTION AND ANSWER SESSION

Question 7

Does ACS or another organization have some

type of support group for the caregivers?
Resources to share?
QUESTION AND ANSWER SESSION

Question 8

How is the absence of caregivers/family support

during hospital visits, due to Covid restrictions,
affecting patient morale and outcomes?
QUESTION AND ANSWER SESSION

Question 9

To protect the cancer patients undergoing

treatment, is the best practice still to get two
negative tests post-COVID positive?
QUESTION AND ANSWER SESSION

Questions received through Q&A portal

Use the Q&A portal to submit

your questions
Wrap up
AMERICAN CANCER SOCIETY
WRAP UP

Resources

We will resources,
For more information and COVID-19 get startedvisit:
at 12:00 ET
cancer.org
Use the Q&A portal to submit your questions to the expert faculty
nccn.org/covid-19
cdc.gov Remember, please avoid PHI/PII

For more about what ProjectThis

ECHOcall
is will
doingbeto
recorded.
respond to COVID-19, visit echo.unm.edu/covid-19
WRAP UP

Join us Wednesday, September 2 at 2:00 ET

Matthew Loscalzo, L.C.S.W., APOS Fellow

Liliane Elkins Professor in Supportive Care Programs (NPI 1437690500)
City of Hope

• Discussion will focus on finding strength as a caregiver during a pandemic.

Rachel Cannady
Strategic Director, Cancer Caregiver Support
American Cancer Society

• Discussion will focus on distilling information about diagnosis and treatment, communication
within the patient-caregiver dyad, and advocating for patients within the health-care team.
 WRAP UP

Evaluation

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the expert faculty

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Email echo@cancer.org with questions.
This call will be recorded.