A cancer diagnosis can be frightening, and can create feelings of uncertainty. It can also be an opportunity to explore your goals, what you value most, and what your wishes are, both for your treatment and your life. Advance care planning can help support treatment plans for all patients—not just those at end of life.
At Rocky Mountain Cancer Centers, Licensed Clinical Social Workers help patients explore those difficult but important issues with guidance from a program called My Choices, My Wishes.
Palliative Care Coordinators can help patients with advance care planning
“Those discussions may not be easy, but it is important to have them early in the treatment process,” says Denise Bickel, PHD, MSW, LCSW, Rocky Mountain Cancer Centers’ Palliative Care Coordinator.
“The best time to discuss patient goals and wishes is before the treatment plan is finalized. Without knowing what the patient wants, or doesn’t want, it is difficult to create a treatment plan that honors those individual preferences,” Bickel says.
The physicians at Rocky Mountain Cancer Centers typically meet with patients and their families soon after diagnosis to go over treatment options. And often, the physicians refer the patient – and the family, caregivers, or loved ones to a social worker to initiate advanced care planning. “The process of identifying goals and wishes is beneficial in helping patients decide on a treatment plan that complements their goals and wishes,” Bickel says.
With the guidance of a trained social worker, patients have an opportunity to discuss their priorities, and to work though questions such as:
- How important is it to be pain free?
- What kind of help will I need, or want, from family members and friends during my treatment?
- Do I want to have nutrition through a feeding tube?
Patients and families can fill out a Patient Values and Goals for Healthcare, and there is a discussion about Living Wills and the Colorado MOST (Medical Orders for Scope of Treatment) form. These collaborative discussions include the patient, family members, and the social worker. Often, these discussions are ongoing and not a ‘one-and-done’ meeting,” Bickel says.
It’s important to have family, loved ones, and caregivers present for these discussions . “Many people worry about being a burden to their family” should treatment side effects make them ill, Bickel says. At the same time, many family members worry that by bringing up such issues with a loved one, “he or she will think I’m giving up on them. And that’s not the case at all,” she says.
For Bickel, walking patients through the advanced care planning process is a calling. “I like to get to know the patient as a person. I can read the chart that explains their medical diagnosis, but that doesn’t tell me about who the person is, their faith, their family, their caregiver, etc. Our intent is to offer a holistic approach to healthcare that addresses not just pain and symptoms but also emotional, psychological, spiritual, practical, and financial concerns. Pain is often resolved with a pill; the emotional aspects of a cancer diagnosis can be much more difficult, which is where the value of social work shines through.
The Supportive Care team at Rocky Mountain Cancer Centers offers individual and family counseling, support services and programs, along with hosting support groups for cancer patients and their families. If you would like support for yourself or a loved one who is going through cancer treatment, please go online here to learn more about the programs available and then call the location most convenient to you.