v4n3 - Resolving Conflict

“Because a cancer diagnosis impacts the whole support network, family and friends may want a chance to weigh in on decisions,” notes Marisa Weiss, MD. Here are some tips for patients and caregivers to resolve or avoid conflicts over treatment decisions:

Communication. Schedule time to discuss options. Let each person talk without interruption. Discuss what you expect from treatment, what’s most important to you, what side effects you consider tolerable, and hopes and fears.

Compromise. If a patient and loved one can’t agree, consider a compromise. If you’re a patient interested only in alternative treatments with a family interested only in conventional treatments, realize that it may not be an either-or proposition. Talk to your doctors about integrating both. Or if you’re a patient opposed to chemotherapy, consider trying one or two treatments and then re-evaluate. “Remember that many decisions are reversible,” Dr. Weiss says.

Decision tools. Many hospitals, clinics and even websites have decision-making tools that can help guide you through the process, notes Marlene Frost, PhD, assistant professor of oncology at the Mayo Clinic College of Medicine in Rochester, who is developing such a tool for women at high risk of a second breast cancer. “It’s a very complex decision that necessitates the integration of much information and weighing of several options,” Dr. Frost says. “So if you can formalize the process and go through it step by step, that can help patients and family members understand the options better.” Her decision tool includes a values assessment worksheet that helps patients decide what’s most important to them—something families could also fill out.

Counseling. Individual, couples or family counseling can help people cope with the stress and anxiety that often accompany cancer, decision-making and conflicts.

Family conferences. Doctors, social workers, nurses or other healthcare providers may be able to meet with patients, family and friends to review options or act as a moderator. If your family is scattered around the country, they may even be able to arrange a phone or video conference. "Remember that people usually resolve differences little by little, not in one session,” says Bonnie Teschendorf, PhD. “But for the most part, families discuss these issues and then fall in behind whatever the patient wants.”