How can I help my mother become engaged with life again after her cancer treatment?
I am my mother's caregiver. She has had two forms of cancer: oral cancer and lung cancer. She has completed treatments for both, the last being chemo & radiation for lung cancer, which completed in July 2010.
The issue now seems to be her lack of motivation and interest in life - maybe depression. She's been on an antidepressent (Celexa) which does not seem to help. Other than going to the bathroom, she refuses to get out of bed. She will not get dressed. She lives in her pajamas. She'll take a shower rarely. She'll "sponge bathe" about every 3 days. She will not leave her bedroom to join me or other family members in any other area of the house. We have a mental health counselor meeting with her weekly. The problem is that my mother is also not truthful with the counselor or with the family. She tries to avoid the appointments by saying she doesn't feel well. She will spend the entire day "pretending" to not feel well in order to avoid this appointment. She also behaves this way when we attempt to leave the house for a small outing.
This has been her life since the first cancer diagnosis in February 2009. Any suggestions would be greatly appreciated.
Expert Answer
First, I have to commend you for managing this for over two years. While it can't be easy, it is relatively common. Cancer patients, especially those fighting multiple types, often don't understand why they are still living -- in fact, they give up on life, trying not to fight the passage to the end of it. This is often regarded as "grieving" or "anticipatory grieving," as she thinks the "best" of her life is gone.
Because you can't "make" your mother act differently, communication is the best tool you have. You'll need to have a very frank discussion with the counselor about your mother's habits, and suggest an unplanned visit. She will be able to assess the situation with her own observations and yours; she will likely look at changing the antidepressant medicine (there are many options) and she may suggest a change of environment - a trip to the park, a walk around the house, or a visit to the library. You should also suggest this to your mother -- show her that the world is continuing around her. With spring, she may have renewed hope in the world. Fresh air might feel good to her as well.
You don't indicate what age your mom is or if she is in otherwise good health. There are respite options for you, where the patient is moved to give the caregiver a day off. Perhaps that would give you a much-needed break and another chance for her to interact with others.
Have you and your mom been able to talk about her cancer? If you have had a conversation about her end of life plans, try to determine if there are any unresolved issues, uncompleted accomplishments or desires she has. What legacy does she want to leave? Maybe you could talk with her about completing these if she's sure she can't go on. It could spur her into some activity and get her re-engaged with life.
It's important also to make sure that her pain is managed. The counselor can help with this as well. Radiation has long-term effects; she could have a lot of trouble breathing, which could also affect her energy levels and motivation to move.
You're doing a good job and this won't last forever. Make sure that you go to her oncology checkups as well -- in this case having multiple healthcare professionals involved will give you more options on her care and more peace of mind.