Older People Living with Cancer

Peer advocates supporting older people affected by cancer


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We too experience loss in our roles as advocates and can sometimes be so focused on supporting others that we do not recognise the loss that we experience ourselves

Today’s post is a really thoughtful piece from Emily Brown, Volunteer Manager at Dorset Advocacy, part of the Dorset Macmillan Advocacy partnership:

It is a sad truth that the people we support at Dorset Macmillan Advocacy have been diagnosed with cancer or are caring for their loved one who have cancer.  It is not unusual then that we come into contact with people who have experienced a great deal of loss in their lives or may experience loss during the course of the advocacy partnership. We, as advocates, often find that we are supporting people though some of the most difficult times in their lives and so it is not surprising therefore that we find ourselves personally affected by their circumstances.  This is particularly true of our Macmillan Advocates as they themselves have had experience of cancer, and so are likely to recognise parallels at times, with those people they support.  As well as supporting people who are bereaved we too experience loss in our roles as advocates and can sometimes be so focused on supporting others that we do not recognise the loss that we experience ourselves. 

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One of the coordinators on our Macmillan advocacy project felt that inviting volunteers at Dorset Advocacy to come together and share their experiences and feelings on the subject of bereavement might help us to recognise these emotionally difficult times and use them to identify ways of protecting and looking after ourselves.

Initially it was thought that this would be specifically for Dorset Macmillan peer advocates, but through the course of discussions about the training we found that the issues raised were likely to affect all of those volunteers who support vulnerable people across the county and that paid advocates too could benefit greatly from this training, so we decided that it should be opened up a wider group at Dorset Advocacy.

Kate Woodhouse (trained bereavement counsellor) facilitated this training on a sweltering hot summer’s day in late July and a dozen or so of us crammed in to the sauna that was Dorset Advocacy’s training room.  There was a mixture of advocates from our volunteer base and paid advocates, all of whom work/volunteer for Dorset Advocacy projects. We spent some time chatting over lunch and sharing ideas and experiences before we reorganised ourselves and sat in a circle.  This was a no-barriers style training and so we were not behind tables with note pads: we were sitting opposite our colleagues, ready to listen and to share.  Kate ensured that we felt safe within this space and asked us to be considerate and respectful to those who spoke as well as those who chose not to.

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Despite the heat it felt as though those who attended were comfortable enough to explore the sensitive subject of bereavement/loss and what it meant to them.  We took turns to choose and present objects that represented our own experiences of loss.  Many individuals in the group used these objects as a means through which to explain a loss they had experienced and reflect upon it.

We were also encouraged to relate personal experiences, worries, anxieties and difficulties to marbles and add them to a jug of water prompting us to consider how we as people can only cope with so much before we run out of capacity. We explored ways that we, as individuals, can look after and protect ourselves alongside offering support to others so as to ensure that we are in a position to give support.

What this training highlighted to me was the importance of having a free and safe space to enable advocates to speak honestly and openly about their experiences.  All of the people at the training had different experiences and had been affected differently by them.  We must remember this and ensure that those people who are offering support and sharing the weight of worries and emotions with others are, in turn, able to share theirs and are encouraged to take time and recognise when to focus attentions on themselves.

Emily Brown, Volunteer Manager, Dorset Advocacy

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‘I don’t know where to start’

Kathleen Gillett of Dorset Macmillan Advocacy looks at the plight of older carers:

We are currently supporting a lady in her late 70s who has a long term health condition and was until only a few weeks ago cared for by her husband.  A sudden deterioration in his health owing to a progression in his cancer has turned the situation upside down and she is now his carer.  With no family in the local area she must alone cope with taking care of things at home that were formerly his domain and at the same time communicating with many professionals with unfamiliar job titles.  No wonder she felt anxious and said ‘I don’t know where to start.’

There have been many reports about the needs of carers over the years.  The importance of supporting carers is widely recognised but until now there has not been a lot of detail about older carers.  Carers Trust have published Caring About Older Carers: Providing Support for People Caring Later in Life which is a toolkit aimed at commissioners of health and social care in England to highlight the needs of carers over the age of 60.

The statistics are compelling. The number of older carers is increasing at a greater rate than for carers as a whole.  Three in five of carers aged over 85 are male and most carers over 80 spend more than 50 hours a week caring.  Carer’s health deteriorates incrementally with increased hours of caring.  Older carers are more likely to have age related illness themselves – two thirds of older carers have long term health problems. One third of older carers have cancelled treatment they needed due to their caring responsibilities.

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Carers of all ages deserve recognition and support. Older carers need the support perhaps more than anyone.  From a financial perspective research has shown that carer breakdown is often a factor in emergency hospital admissions and admission to residential care.

The toolkit chapters identify areas of need for older carers including health and wellbeing; financial concerns; social isolation; concerns for the future; information and advice; assessment, support planning and involvement and finally bereavement and life after caring. Examples of tried and tested practice are given with each of the chapters and particular mention is made of the role of advocacy services in representing and supporting carers with assessment, support planning and involvement.

We were able support the lady at an appointment with the hospital’s palliative care coordinator. Then we accompanied her to view a nursing home where her husband could be admitted to receive the palliative care he needs. She was able to make preparations and the following week her husband’s planned discharge from hospital took place.  The nursing home location is easier for visits and there are no restrictions on visiting hours and the possibility of overnight stays for family members.

Older carers struggle to remember their own needs and to look after themselves.  The support and encouragement that peer volunteer advocates can bring to older carers affected by cancer can make a huge difference to them.


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How our steering group helps us to network and build partnerships

Our Local Cancer Champions Board, the steering group for Dorset Macmillan Advocacy, changed its name in 2014 to Cancer in Older People Development Group.  Members wanted to create a group that could, in addition to overseeing our service at strategic level, bring together people interested in improving patient experience for people over 50 affected by cancer and their carers. They felt that the new name was more self explanatory and we are fortunate to have an interesting mix of people on the group.

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As Dorset Macmillan Advocacy is delivered by two organisations in partnership the steering group sought to meet alternately on different sides of the county.  Meetings have been hosted since 2014 by Lewis Manning Hospice in Poole and since last year by Joseph Weld Hospice in Dorchester.  We have benefited from learning about the hospices and our presence there has raised our profile with their staff and visitors.

We also invite local guests to the group meetings such as the project lead for the Macmillan Information Scoping Project which took place last year and the director of Dorset Living Well Active, a physical activity project which is a partnership between Macmillan and Sport England.  The group can explore joint working at both strategic and operational level and this really enhances the daily  networking that staff and volunteer advocates do.

The new Chief Executive of Weldmar Hospice Care Trust, Caroline Hamblett, joined our last meeting in May and described the variety of community services that the hospice provides. Senior Sister Sally-Anne Baverstock then gave the group a tour of the facilities which include 14 in-patient beds all with views over the beautiful garden and countryside beyond.  We’ll arrange a visit for our team of volunteer advocates in the near future.

Steering group visit Joseph Weld Hospice

Pictured left to right are Sally-Anne, Paul Hickman, Chair of Trustees at Help and Care, Emily Brown, Senior Volunteer Coordinator at Dorset Advocacy, Jenny Rimmer, Macmillan Senior Advocate at Dorset Advocacy, Bob Smith, volunteer advocate.

Kathleen Gillett, Dorset Macmillan Advocacy

 

 


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I have gained a lot from her and she has made me stronger just by listening to her

In today’s Volunteers Week story we hear from Audrey one of our volunteer peer advocates who supported Eleanor who had been diagnosed with terminal lung cancer:

Eleanor is a very strong person, she is coping with her cancer as well as keeping her family happy. I really do admire her strength. She has a strong family around her. Although she is sad her two sons will not be around she does have contact with them. She just wanted to sort her house out; she wanted to decorate and renew as she is leaving her house to her daughter. This she was able to do with the extra benefits she was entitled to.

She is suffering with lung cancer and it’s terminal. Her treatment this time around is harsh, she is losing more time to the treatment than she is to the cancer. She has decided she is not having any more treatment unless it will give her more time. I have visited her at home and will continue to do so.

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Audrey

She was referred to our service through a relative of mine who knew we did something with cancer advocacy. She was worried about how she was going to manage on the money she had as she had lots of things she wanted to do before the cancer stopped her.

When I first met her I realised we knew each other by sight, but not by name. She was okay with this and so was I. We talked about times gone by when we were both younger and got to know each other quite well. She always asks how I am when I go and visit. She never sits and talks about herself unless I bring up the subject by asking what she has been up to; hospital visits or appointments she is waiting for.

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I have gained a lot from her and she has made me stronger just by listening to her. She never feels sorry for herself even when the treatment has her down. She still manages a smile. She has had her money sorted and has done her house the way she wanted. She has had a couple of holidays which is what she wanted. She is sad at the minute, because of the treatment she has lost days. She could have been doing so much if she did not feel so tired. She is pain free but struggles to breathe.

I still see Eleanor regularly to give my support to her through her good and bad days. I am there when she needs me to help her.

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You can read Elinor’s story in full along with Audrey’s view in our publication Every Step of the Way which can be accessed here

 

Marie McWilliams, OPAAL


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I became a peer advocate because having had cancer, I felt that I could be of help to other people.

Deb McGarrity, delivery partner AgeUK Northumberland’s paid advocate, gives us an insight into what it’s been like delivering the older people’s cancer advocacy service in Northumberland recently. In what is Volunteers Week, Deb also introduces us to Marion, an older person affected by cancer, who has become a peer volunteer advocate:

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Since the end of last year the Age UK Northumberland Macmillan Cancer Advocacy and Older People project has steadily been receiving referrals, there have been 24 cases since December 2015.

Without a volunteer coordinator it has been a challenge to keep our volunteers engaged and supported, this has partly been achieved through a good relationship with local Macmillan who opened up their volunteer training schedule to our volunteers. Our volunteers have taken advantage of the Macmillan training by participating in training in Bereavement and Loss, Specialist Palliative Care, Cognitive Behavioural Therapy and Prostate Cancer.

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Volunteers have also accompanied the paid advocate on visits and are slowly beginning to have their own cases. One volunteer, Marion Young has started working with a client who recently was given a terminal diagnosis. When I asked  how she feels about being part of the project, Marion responded by saying:

I became a peer advocate because having had cancer, I felt that I could be of help to other people. I am looking after my first client who has been given a terminal diagnosis. With the guidance of Deborah and the client’s permission I have written letters to the GP and Macmillan to support her with her request to be able to move nearer to her daughter. I am going with her to the hospice. I am meeting with her beforehand to note any questions that she has, giving her empowerment that enables her to understand what will happen.

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Marion Young

From my own point of view it has been great being able to include the volunteers in client case work. Not only are we utilising their experience to help our clients but I too am learning from them which is extending my expertise and informing my practice. I can see too that the clients also really appreciate having someone to support them who has also been affected by cancer.

Deborah McGarrity, AgeUK Northuberland


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Emotional exhaustion

I’ve just watched the BBC One programme The Big C & Me. I didn’t watch it because I wanted to rather I watched it because I felt I should. As the mother of a now 25 year old son diagnosed with secondary cancer almost 18  months ago I now realise that I have been actively avoiding programmes, books and articles about cancer.

Now that’s a bit ironic when I do the job I do and which currently is heavily focused on advocacy for older people affected by cancer. Personally, I call it self-preservation.

Well, watch the Big C & Me I did. It tells stories of real people affected by cancer. It has happy moments and deeply sad moments and this is only episode one. It’s narrated by the BBC’s own Victoria Derbyshire who was diagnosed with breast cancer last July and who filmed her own breast cancer diary.

While watching the programme it really hit home to me where our peer volunteer advocates make the biggest difference when supporting other older people affected by cancer. It’s because they’ve been there, done that and have the t-shirt. As I watched Yvette, one of the three people featured in the programme, receive bad news I relived that moment when my son received his traumatic news. I know all too well that heave in the pit of your stomach. Our peer advocates know that heave too. They understand the absolute emotional exhaustion that can take hold at any point in the long haul of living with cancer.

Our wonderful medical staff treat those diagnosed with all the tools available to them. However, unless they’ve actually been on the receiving end of a diagnosis they can’t fully comprehend the impact. Our advocates can and that’s what makes the support they provide so unique. It’s that understanding which nurtures the supporting and empowering advocacy relationship.

One issue raised in last night’s episode of the Big C & Me was about how those affected by cancer don’t want sympathy. Ideally, they don’t want friends and acquaintances to treat them any differently than before. With that in mind the BBC and the Open University have produced a booklet entitled The Big C: Making a difference for people living with cancer. To find out more and to order a copy of the leaflet click here

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The Open University is also running a discussion hub “What is helpful for someone undergoing treatment for cancer: Which little kindnesses can you employ to help someone who is undergoing treatment for cancer and their families?” You can join the discussion forum here to have your say.

Marie McWilliams, OPAAL


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The Big Conversation

Every year in May, Dying Matters and its coalition members host an Awareness Week, which gives an unparalleled opportunity to place the importance of talking about dying, death and bereavement firmly on the national agenda.
It’s Awareness Week this week and it runs from 9-15 May with the theme ‘The Big Conversation’.

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Did you know that research carried out during last year’s awareness week discovered that:

  • 71% of the public agree that if people in Britain felt more comfortable discussing dying, death and bereavement it would be easier to have our end of life wishes met
  • Just 35% of adults said they had made a will
  • Just 27% had let someone know their funeral wishes
  • Just 7% had written down wishes or preferences about the care they would want if they couldn’t make decisions
  • Just 18% had asked a family member about their end of life wishes

Our colleagues at Dorset Macmillan Advocacy are supporting Dying Matters week. Their display stand is promoting Advance Care Planning and the Cancer Older People and Advocacy service in Christchurch library all week.

Dying Matters Week DMA display at Christchurch Library

You can join in The Big Conversation by looking out for and attending local events.

  • You can also follow Dying Matters on Twitter, Facebook, LinkedIn, YouTube and Pinterest. 
  • You can Tweet about it, always including the hashtag #BigConversation.
  • You can also join in the #BigConversation on Twitter. Between 1-2pm GMT every day of Awareness Week Dying Matters will be hosting a Tweetchat on a variety of topics relating to dying, death and bereavement – and they’d love you to join in. Find out more

To find out more and see how else you can support The Big Conversation, click here

Marie McWilliams, National Development Officer, OPAAL