Cancer Caregiver Roles

Cancer Caregiver Roles

In 2012 about 1,638,910 new cancer cases will be diagnosed, according to the American Cancer Society.

That means over 2 million people, including family and friends, will be impacted by these results.

John J. Garnand, PhD, knows first-hand how loved one's cancer diagnosis effects multiple lives.

His new book, Cancer Caregiver Roles, is a love story that chronicles his nine-year journey with his loved one as she dealt with cancer, from diagnosis until death.

Serving as a guidebook for caregivers, it showcases how one diagnosis will change multiple lives and shift the focus of what is truly important.

Additionally, it breaks down the three roles of the caregiver: medical support, insurance and financial management and household management. By providing a deep explanation of these necessary roles, Garnand hopes that this compilation will help other patients and their caregivers become more loving and more proficient in their cancer journey together.

'My hope is that this compilation will help other patients and their caregivers," Garnand says. 'I believe this will help them become more loving and more proficient in their cancer journey together."


John J. Garnand has spent a lifetime as a teacher and coach. For over two decades, he was an award-winning instructor in business strategy, management operations, ethics and public policy. Recently, he retired from the Leeds School of Business of the University of Colorado at Boulder. Garnand currently lives in Fort Collins, Colorado.


Cancer Caregiver Roles

Author: John J. Garnand
ISBN: 9781452553450

Interview with John J. Garnand

Question: What inspired you to write this book?

John J. Garnand: Dedication: "to honour Family Caregivers-that exhausting, noble, deepest expression of human love and to honour my deceased wife Susan Marie". It is my hope that her stories built into the text will "...teach and inspire them to become more loving and more proficient in their new life journey together."

Truth be told, I really don't remember any noble or altruistic motivation when I sat down to write. I only remember I HAD TO WRITE this book. Maybe it was a lifetime of teaching that subliminally drove me to share our experiences with other newly diagnosed cancer patients. Teachers are supposed to prepare their students for what is to come, and suggest ways they can succeed or survive. The key line in a Commencement Address that I gave at the University of Colorado was "I hope we have taught you how to live, as well as how to make a living." Maybe the Teacher experiences took over and forced the authorship of this book.


Question: Who did you write this book for?

John J. Garnand: I had in mind the newly diagnosed cancer patient-maybe in mid-life, who has the most to lose financially. When we first went to the Cancer Center for chemo infusion in 2001 almost everyone in the room was from the older geriatric generation. I remember looking around the room during our last chemo in 2009 maybe a third of the patients were in their 30's to 50's. Many sat tubed up to the chemo bags, with children or toddlers playing at their feet or colouring in books. Sometimes dad was there walking out in the garden with one or two of the children. Cancer diagnosis is coming to a much younger generation...and these usually have the tightest resources. If mum is going to be here for 3 - 4 hours, arrangements have to be made for children.

This book was written for cancer patients, focusing on the definitions, treatments and diagnoses particular to the cancer journey. But it applies to ANY debilitating and progressive disease-MS, Diabetes, rheumatoid arthritis, ALS…

It replicates and uses the same diagnostic procedures, and caregiving requisites. Only the definitions and treatments are specific to cancer. And the chapters on laughter and epilogue on end of life are universal in their applications.


Question: Did you find it difficult to relive some of your past experiences when writing?

John J. Garnand: Of course. There were many times I stopped typing to just read over what I had just written, and pray or cry. But my experience with the dying as a volunteer with Hospice has taught me that grief is the internal black hole in your heart, stemming from the deep sense of loss. You can't get around grief; you have to get through it and mourning is the outward expression of grief. It makes you face the realities you have experienced... and appreciate the final gifts you each gave to each other. Only the expression of grief-mourning-is cathartic, and gets you through it. This book allowed me to chronicle our final gifts to each other, and as such, it was tremendously relieving.


Question: What tips can you give us for time management?

John J. Garnand: This question sounds so academic: The reality of caregiving involves a deeper and swirling involvement in just holding everything together. The best metaphors I can think of for cancer are a swirling vortex sucking you into oblivion, or falling into an unexpected quicksand where you cannot feel any bottom, and you feel yourself sinking relentlessly until the mud covers your face.....and you cannot breathe. The best tip I can give is to remain in touch with a close group of friends, or someone you can call to talk to. It becomes a planned event just to get to the grocery store for food.

I can remember being told to take breaks, or get respite care. I would think of this as a diarrhoea episode would hit...and wonder when would you get time for respite care? Caregiving easily becomes 24/7 attention and surveillance. There are no breaks, because there are no breaks in life, and this is your life now shared with your partner. And my best reminder would be to join a Support Group that meets on a regular basis, so your participation can be planned.


Question: What do you hope readers take away from this title?
John J. Garnand: The bottom line is, cancer is extremely expensive to diagnose and treat. My wife was on a daily medication to inhibit estrogen from feeding the cancer cells; this came to $56,000 per year ($4737/per month). She had one chemotherapy regimen that was $48,000 for three months. We had treatments that totalled more than $100,000 alone; we include oncologists and physicians, diagnostic procedures, and lab work, and the total for the year came to $197,725. It was like this for the last four years. I found a way to cap the financial haemorrhage: the "Out-of-Pocket Maximum Plan," or stop loss plan.

The normal, every-day couple needs to know this! If they face the cancer journey without this information, they will predictable lose their savings, and possibly their home. Over 70% of all bankruptcies in America have a medical basis, and 80% of these bankruptcy victims had 80% - 20% insurance....and many go on to lose their homes as well. In the above example, if we had opted for 80% - 20% insurance, I would have had to pay 20% of $197,725 or roughly $39,545 out of our own resources. Suppose my wife had needed a stem cell transplant, or surgery to remove the large brain lesion around her brain stem; add another $150,000. Now we owe 20% of $347,725 or $69,545 out of our own pocket!

The common middle class person just cannot sustain these costs. But we are talking about your loved one, your life partner, your spouse. Your impulse is to do "whatever it takes" to keep her alive. Everyday middle class couples are facing these crises on a daily basis in America.

It is the common experience of cancer couples: You get diagnosed with a terrifying disease, and it crushes you financially as well-unless you are somehow well prepared and informed.