Help & Care
Caring for Someone

How your Relationship Changes

Caring for someone with cancer may affect your relationship with them. Most carers agree that the relationship is under greater stress during the diagnosis and treatment.

Facing challenges such as cancer together may strengthen some relationships, but others may be strained. The impact on your relationship may depend on what your relationship was like before the cancer diagnosis.

If you have a strained relationship with the person you care for, the pressure of cancer treatment and the demands of caring may add further tension. You may want to share the caring role with other people so you are not the full-time carer.
Cancer often changes family roles. If you are caring for your partner, you may have to take on many of their responsibilities. Discuss with your partner how you feel about the change in your roles and how you will restructure your life during cancer treatment. Try to include your partner in household decisions and ask for their advice. Work together as a team. They will appreciate that they are still an important, contributing member of the family, despite the cancer. Talk to your children about these changes.

You may not want to take away all of your partner's jobs and responsibilities. Being able to do things may make them feel useful and help maintain their independence, dignity and sense of control. 

When you have established your new roles and responsibilities it may be necessary to ask others for help. Discuss the various job allocations with your partner. 

Gay, lesbian, bisexual, transgender or intersex (GLBTI) people may face extra challenges when caring for their partner. They may worry about their family accepting them, or wonder if support services are GLBTI-friendly.
You and your partner may find the cancer and its treatment affects your sexual relationship. How it affects your sex life will depend on the type of cancer, the treatment and its side effects.
  • Tiredness can make people lose interest in sex during and after treatment. This is called a lowered libido.
  • Pain, medications and treatment can also reduce sexual feelings and desire. They can also affect someone's physical ability to have sex.
  • A person's body image may change after treatment, making them feel self-conscious and embarrassed.
  • The emotional strain of cancer or caring may mean you are preoccupied and lose interest in sex.
  • Many people worry that touching their partner intimately will cause pain.
There are some ways you may be able to improve your intimate relationship with the person who has cancer. 

Tips
  • Restore the intimacy in your relationship by spending time together. If your partner is well enough, you may be able to go to a movie or out to dinner. Otherwise watch a DVD together, give each other massages, read the newspaper together, look through old photo albums, or talk about how you first met.
  • Tell your partner you care. Your partner may need reassurance that you love them and find them attractive despite the physical changes from cancer or treatment.
  • Discuss any fears you have about being intimate with your partner. If you keep quiet, your partner may misinterpret your distance and think that they're no longer desirable. Many people feel embarrassed talking about their sexual needs, but being open can help you identify changes you need to make.
  • Keep an open mind about ways to feel sexual pleasure. You may need to try different things if your usual ways of lovemaking are now uncomfortable or not possible. For a while you may need to focus on kissing and cuddling. Some people find lubricants or vibrators help.
  • Take things slowly and spend time getting used to being naked together.
  • Be patient. You will probably find that any sexual problems after cancer improve with time and practice.
  • Talk to a counsellor who helps couples with intimacy and sexual issues.
There may be certain tasks that the person you are caring for does not want you to help with, such as having a bath or shower or going to the toilet.

It may be hard to step back and let the person with cancer do things for themselves, especially if you can see that they are finding the task tiring or painful.

If the person refuses your offers of help, you should respect their request. If you have concerns about the person's safety, place a bell nearby to ring if they need assistance. You may suggest that you will come back every 5 to 10 minutes and call out to make sure they are okay. You can also talk to your doctor or nurse to get some in-home help.

The person you are caring for may do something that you feel could be harmful, such as refusing medications or wound care. If this happens, try talking with them and discussing their feelings.

Another family member or close friend may be also able to be a positive influence. If this doesn't work, you should seek support and advice from the medical team. They may be able to discuss it more objectively with the person with cancer.

Carer Life Course
Carer Life Course Australia is a website with information about different stages a carer may go through. It covers information about how a carer may feel and how their relationship may change over time. It also has links to other useful web-based resources. Visit http://www.carerlifecourse.org.au/.
You might try to be a carer and find it hard to manage. Sometimes the changes in your relationship make caring too difficult. It might help to get professional counselling, either alone or with the person you are caring for. The counsellor may be able to discuss if there is a way to make the caring arrangements manageable. If not, you may be able to get advice about how to change to a different arrangement with the least amount of stress to you both.

Ask your GP for information on how to get a referral to a clinical psychologist.
There may come a time when your assistance is not needed as much. It may be because the person you are caring for is getting better and trying to resume their normal life. This may make you feel a bit lost or redundant. 

The person you are caring for may gain a new independence and appear to have forgotten how much time and effort you gave. This can be hurtful, but the person with cancer is probably not aware of how you are feeling.

You may think that you can slip back into your day-to-day life as it was before you became a carer, but this can be challenging.

You might feel you are still on call for the next setback. Your life may also have changed. Going back to work or resuming other responsibilities you had put on hold can be overwhelming. Do things at your own pace and give yourself some time to adjust. You might be able to return to work part-time or take on fewer responsibilities.

Talking about your feelings with someone you trust can help you to process the changes and think about what is next.
When someone is diagnosed with cancer they may experience a range of emotions such as shock, fear, irritability and anger. You, as a carer, may also feel this way. This can affect communication, which is an important part of any relationship.

People who frequently share their feelings may be better able to talk about cancer. If you usually solve problems or make decisions alone, it may sometimes be more difficult to communicate.

Talking
It can be challenging to talk about cancer, its diagnosis and treatment. This may be because you:
  • fear saying the wrong thing
  • don't know what to say and how to respond
  • feel you shouldn't talk about the cancer
  • don't want to say something upsetting
  • feel you have to be supportive and strong for the person with cancer, and worry you could break down
However, many people find talking helps them cope better with the cancer diagnosis. It also helps couples know how one another is feeling and creates a bond between them.

Listening
Listening is an important part of communication, and helps others talk about how they're feeling.
Ways to be a good listener:
  • Sit somewhere private where you will not be interrupted.
  • Relax and show you are there for as long as needed.
  • Signal that you don't want to be interrupted, e.g. switch off your mobile phone.
  • Maintain eye contact.
  • Ask if the other person feels like talking.
  • Focus on the person and listen carefully. Try not to think about something else or plan what you will say next.
  • Ask open questions to get the person with cancer talking.
  • Don't interrupt or change the subject.
  • Allow the person with cancer to be sad or upset. You don't have to keep them happy and in good spirits all the time.
  • If the person interrupts you, ask them to wait until you've finished.
  • Make sure you have understood what they've said, e.g. repeat back information or paraphrase.
  • Try not to give advice, but prompt the person to think about their options. If you do give advice, don't give it too early.
  • Respond to humour.
  • If the person stops talking, give them some time to gather their thoughts rather than filling in the gap.
During your role as a carer, there may be times when you disagree with the person you are caring for. It's normal to have disagreements from time to time. Although dealing with conflict is stressful, it can also be a good way to get closer to the person you are caring for and understand their point of view.

If you can't resolve your differences or if the caring situation becomes too stressful, consider taking a break from your caring role or organising another caring arrangement. 

Tips
  • Talk to the person you are caring for about your concerns. Let them know that you care about them and want to resolve your differences.
  • If you disagree on something important, try to stay calm and talk through the issues involved. Hear each other out and try to make a decision together. Sometimes people disagree because there has been a misunderstanding.
  • Compare your goals and expectations. For example, some people with advanced cancer choose to stop having treatment to cure the cancer.
  • This may be difficult to accept if you want the person to keep having treatment.
  • Choose your battles - it may help to focus your energy on the issues that really matter.
  • Ask your family and friends for help and support.
  • Talk to your GP or medical team. You might be able to get a referral to a clinical psychologist or social worker who can talk to you about what you are going through. 
Acknowledgements
We thank the reviewers of this booklet: Jane Ussher, School of Psychology, University of Western Sydney, NSW; Piero Bassu, Consumer, NSW; Lindy Cohn, Cancer Information Consultant, Cancer Council NSW Helpline; Dr Mandy Goldman, Cancer Counsellor, Private Practice; Christine Harris, Consumer; Joanna Jarrald, Assistant Project Coordinator, Cancer Council NSW; and Colleen Sheen, Executive Manager, Policy, Strategy and Communication Unit, Carers NSW