Oh, I’ll bet you’re expecting me to tell you all about how to teach your loved one with cancer to appreciate being alive at Thanksgiving, how to embrace the mood, the moment, the celebration. After all, we gather to give thanks for what we have, as extended families bring green bean casseroles and pumpkin pies in Pyrex and Tupperware. What could be a bigger downer than having a loved one with cancer at Thanksgiving? I’ll tell you. It’s having a loved one who is disrespected at Thanksgiving.
That’s right. Disrespected. Flat out disrespected.
How can I even suggest that, when everyone is trying so hard to be inclusive of someone who’s struggling with survival? I’ll tell you how. That’s because I’ve witnessed it more than once. (I’ve also heard it from a number of cancer survivors, how the family dynamics change.) The loved one with cancer becomes overwhelmed, physically and emotionally, trying to keep up with the party, and suddenly it’s an up-in-your-face reminder that you’re dining with the Big C.
The trouble is that healthy folks, who may not have any insights into how cancer takes its toll, are still in B. C. mode (that’s “before cancer” for those of you who are new to the game.) They often like to eat themselves silly with all of the classic Thanksgiving Day staples, like cheddar broccoli and stuffing with sausage. They can’t wait to get their hands on the drumsticks, the dinner rolls, and especially the desserts. Nothing is going to stop them from partaking in all the food and fun. They’re on a mission, a Thanksgiving Day mission.
Meanwhile, your loved one may be struggling with some very real physical and emotional issues that need addressing. Now that cancer has rocked your loved one’s world, it’s time to adapt to the reality of those changes.
Does that sound complicated? Do yourself a favor and don’t over-think it. Concentrate on two things. Food and rest. It’s really that simple.
For a cancer patient, especially one still undergoing chemotherapy, the holidays can be exhausting in many ways you have probably never experienced. Here are some important questions to answer:
1. What time of day does your loved one have the most energy?
2. What time of day does your loved one have the least energy?
3. What time of day is your loved one best able to enjoy a meal?
4. Will your loved one’s chemo fatigue kick in, and will he/she need to take a break?
Bottom line? It’s just possible that your loved one just doesn’t have the stamina to endure the Thanksgiving Day celebration. Are you hosting or are you visiting? If you’re hosting, it’s fairly easy for your loved one to slip away and lie down when he/she is tired. But if you’re visiting, you’ll need to speak to the hosts ahead of your arrival. Ask if there is a quiet room where your loved one can rest, should the need arise. Sometimes just lying down for an hour or so can keep a loved one at the party.
Some cancer patients make special arrangements for chemo treatment to accommodate the holiday, so that they don’t “crash and burn” on Thanksgiving. They talk to their oncology team early and discuss strategies to cope with this issue. Encourage your loved one to do this and sit in on the discussion, so you understand what’s going on in chemo treatment.
Remember to err on the side of caution if your loved one’s immune system is conked out. Better safe than sorry, especially during flu season. Hand washing by guests is critical. Avoid kissing and hugging. If the risk of infection is too high, consider staying home and having a video chat with those near and dear.
If you and your loved one have a long drive to make, be sure to bring along a pillow and a lap blanket, so your loved one can get comfortable. Consider the drive to be “rest time” and make it relaxing for him/her.
When it comes to the Thanksgiving meal, know what your loved one is able to tolerate. Many cancer patients can’t eat certain foods. If you’re hosting or you have a good relationship with the hosts, work on a menu that will please the turkey traditionalists, but will also provide foods your loved one can and will eat.
Very often, families aren’t aware that cancer patients find eating to be an exhausting process. Chewing will actually tire them out. The nutrition team at your loved one’s cancer center can help you plan a banquet that includes foods that will provide the necessary calories and be easily digested. They often have all kinds of tricks for adapting foods to make them even better. Not every cancer patient is going to have the same diet. Different chemo drugs and different types of cancer create different dietary needs. If your loved one is experiencing diarrhea, for example, greasy foods may exacerbate that situation and cause distress. That’s why it’s important to sit down with a cancer nutrition expert and understand how best to meet your loved one’s specific dietary issues. Consider it part of the medical treatment plan.
Got a good recipe for butternut squash soup that you know your loved one enjoys eating? Serve it as part of the family meal, so your loved one won’t feel singled out for special treatment. Will there be appetizers before dinner? Cancer patients sometimes do better when they nibble than when they sit down for a huge meal. In this case, he/she won’t “ruin” his/her appetite. Don’t draw a lot of attention to your loved one’s eating. With healthy, digestible food choices present, your loved one can eat as he/she sees fit.
Understand that chemotherapy can change how foods are digested. It can also change how they taste to your loved one, and that can and will affect appetite. This is usually a temporary thing. Some cancer patients who love dairy develop lactose intolerance, much to their dismay. Some patients can’t digest raw vegetables, so cooking them can make a difference. Some fruits go down easier than others. Very often, the recommendation from nutritionists is to puree foods, to make them easier for cancer patients to eat. Smoothies don’t require chewing and they’re usually quite soothing to sip. (Have I convinced you yet to talk to the cancer center’s nutrition team yet? I hope so. They’re more than willing to help you feed your loved one.)
Remember to leave the food police at the door when guests arrive for the Thanksgiving celebration. No one should be commenting on your loved one’s food intake, insisting he/she eat this or skip that. Sometimes a spoonful of sugar, in the form of human compassion, is the best medicine to go down. If you and your loved one know ahead of time what foods will work and what will not, there’s no need to explain or defend yourselves. Just smile and say, “Thank you for your concern, but we’re following doctor’s orders.”
With all this talk about food and fatigue for cancer patients, I don’t want to neglect a very delicate subject. Holidays can bring out the worst in some people. Tensions run high with elevated expectations of “instant happiness”. Some families bicker. Some families think there are only certain ways of doing things. A cancer patient’s needs can and should come first. Work around them. Adjust the celebration to accommodate your loved one at that moment in time. If that means you eat an hour or two earlier or later, so be it.
What do you say if a family member balks? You say this: “I know we normally do things that way, but this year, we’re going to do it this way. And I’m sure when our loved one is back on his/her feet, we’ll go right back to doing it the way we’ve always done it.” Treat any changes in holiday traditions as temporary, because they usually are. When families know that you’re not throwing out the time-honored traditions permanently, you’ll often find greater cooperation and willingness to sacrifice.
Most of all, when you all sit down and look across the table at each other, focus on why it’s so good to be there. Appreciate the family for the people in it. Take the time to laugh, to share stories, to toast another year of life for all of you. You have this time, this moment to share. Make memories.