The Dos and Don'ts of Helping

Pooled advice from patients, clinicians and caregivers

Dashing into the grocery store, we suddenly come face to face with a friend who is undergoing a grueling round of treatments for a challenging disease. We look up, down, anywhere but in her eyes as we mumble something awkward.

We cringe at the sound of our own voices.

What we really want to say is, ‘Help me help you. I don't know what to say.’

Below is a list of pooled tips from professionals and patients for traversing the rocky landscape shared by those who are well and those who are sick.

If you have a friend or loved one who is ill or has a chronic disease:

• Talk to the person as a person. The disease did not change your friendship. It shouldn't change the way you interact.
• Talk about the same things you always talked about-children, pets, gardening, work, movies, books.
• We filter out or place barriers between us and moments that make us feel helpless, vulnerable or uncomfortable. Let an ill person teach you to be open to roads toward intimacy: Listen to what the person with the illness is saying with as few emotional filters as possible.
• It's easy to confuse listening with hearing. Truly hear them, while you are listening, without thinking about the next helpful thing you can say in response.
• Remember that, sick or well, we all have good and bad days.
• Think of ways in which you can let a person know you care. Send a card or an email. Leave a message on their voicemail. Have flowers delivered. Make food for the patient or the family. In other words, send a bit of you to them.
• Ask yourself how you would react to the friend if the experience weren't so severe. If your friend had had a flat tire on a rainy freeway that day instead of cancer, would you really throw out such platitudes as, ‘We are only given what we can handle,’ or ‘There must be a purpose for this tragedy.’
• Don't say to a sick person, ‘Let me know what I can do for you.’  That just puts the burden on the person with the illness. Often, he probably doesn't have the energy to find a pen to write down your phone number. He may not know what to ask for or is embarrassed to ask for help at all.
  
  Say instead, ‘Would it be OK if I check back with you in a few days to see if you need something? Let me think about what I can do for you.’

• Pay attention to the cues your friend may be giving you. Maybe you just need to be with her. No need to talk. Maybe she's asking for encouragement.
  
  If you are unsure, ask, 'Do you need me to listen or do you need my input? Either way is fine.'

• Illness is a story, a saga that may need to be told and retold. Try to bring a fresh ear to your friend.
• Conversely, some people may not wish to share the details of their hospital stay or their emotional roller-coaster. Allow them their privacy. Silence can be deeply intimate.
• Ask your friend before you share information with other loved ones. Perhaps she would prefer that you share her condition with her other friends so that she doesn't have to call a roster of people with every update. Perhaps she would prefer that you develop a planned response for other inquiring friends. Perhaps she would prefer utter discretion. It is, after all, her story, not yours.
• Simply stating, 'I have no answers for you, and I honestly do not know what to say' is honest, authentic and validating.
• Unless you are sure your story-swapping will be of help, try not to say, 'I know exactly how you feel.' Even people with the exact same type of cancer experience their illnesses uniquely.
• Offer to write thank you notes or make phone calls for the person, if he is worried about acknowledgements. At the same time, gently remind him that no 'thank you' is required-the act of giving to someone who is ill is the giver's way of saying "Thank you for letting me into your life."
• Resist the temptation to give advice, unless asked.
• Remember that compassion is not pity. Compassion goes back to the commitment to being still and being able to tolerate-to be present with-- someone else's pain.
• Know that if you run into even a casual acquaintance, you can inquire about their circumstance: 'How are you? I heard you have been ill. How are you feeling now?' The person with the illness would much prefer that you say something, rather than to ignore the obvious.
• Be polite. The book title Everything You Need to Know You Learned in Kindergarten is true.
• Most importantly, make the person who is ill more important than you are when you are with him. That includes your feelings. Think about what that person is going through. It is so much more important than your discomfort with his illness.

If you are the person with disease:

• Let people help you. Helping is their gift.
• If you need something, ask for it. Denying someone the chance to assist makes others feel helpless.
• Do NOT think that it is wrong to have a down day. Even perfect health brings down days.
• Resist the need to take care of your caregivers' sadness or discomfort. Have faith that they will work through it.
• Remember that some people help by making chicken-soup; others, by listening well. We all have our unique gifts to bring.
• Crying is the first response we had when we came into this world. If you feel like crying, go ahead. It expends energy; it is natural.
• So is laughing. It's OK to laugh your head off, too.
• Ask a loved one to write down things that you need and then think about whom you might ask to do those things for you.
• Let your friends know that you may be sick but that sickness has not affected your affection for them.
• Do not confuse your Self with your disease. You are not the shirt you wear or the disease that is sharing space with you.

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Updated: 3-25-2005

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