The financial strain of cancer..

This is a subject that many people don’t consider when first diagnosed with cancer. The enormous stress such a diagnosis brings negates the ability to think coherently.  However as the days, weeks and months pass by a slow realisation dawns on what a huge financial impact a cancer diagnosis has on our lives. Time off work, prescription charges, doctors fees and transport costs are but a few of the drains on ever dwindling resources. Yet it has been suggested that after the initial diagnosis of cancer that this is the critical period when people most need support and advice to avoid long-term financial problems.

When healthy and well no one likes to think of being seriously ill and what a huge impact it could be  when a member of family gets ill. In an ideal world most people would try to save a little nest egg for such unexpected life events but in reality the day-to-day grind of getting by lingers on for most people especially since the recession. Taking time off work may be a severe financial strain for some families who have monthly mortgage repayments as nowadays most households are dependent on two salaries.    Getting the best mortgage protection insurance, such as critical illness cover,  when purchasing a house would enable a family to pay the full mortgage when seriously ill.   I am not sure if this is promoted nowadays but it is something I recommend to anyone I know starting off with a new mortgage. If you have difficulty getting critical illness cover,   (most lenders won’t give one after a diagnosis of cancer), you could consider extra life insurance cover so that if the worst scenario possible happens as least your family is protected.

Most governments in the developed world have supports of varying degrees for its citizens. The problem is trying to access the information. Having had to deal with the huge stress of being diagnosed with cancer , organisation of financial affairs appears a monumental task and can sometimes be neglected in the early days. Hours can be spent researching and checking what someone’s entitlements are.   Wading through the social welfare system can be onerous at times but when having to deal with it on treatment can be completely overwhelming.  I found the task of filling out forms too much and kept procrastinating for about six months until I received a bureaucratic letter stating that I will have to resubmit my forms again.  In hindsight I should have sought help and advice but hadn’t the energy to follow it up.

 

What the research says

A recent survey, in 2015, from the Irish Cancer Society on the real cost of cancer highlights how the stressor of a considerable financial burden  could easily add to the psychological stress already experienced.
Indeed other research has found that financial concerns of a patient  change over time and in order to capture this it was recommended that a standardised assessment protocol be established  to routinely screen patients at multiple times during their care. It seems like stating the obvious but education of patients and providers can help people make informed choices and be able to access financial resources in a timely fashion. This is something that  I feel is fundamental to empowering people  because otherwise how can people avail or access services if they had no knowledge that the actual service exists! The Irish Cancer Society speaks of how easily someone may fall through the support net simply because people may not be aware of their benefits or may be too ashamed to ask for help.        Not surprisingly research has also noted that people with  low incomes, who are younger when diagnosed,  people on chemotherapy and those who in a rural part of the country were also associated as having a greater financial burden when diagnosed.

So.. what can you do?

Many people need to take time off work for treatment. I certainly did, even if my job was non-physical, I don’t think I could cope with the psychological elements of a cancer diagnosis and resultant side effects of treatments.
If you are not aware of your workplace’s sick leave policy, check it out and see what you are entitled to. When you are satisfied arrange to meet your employer. Most employers are very supportive and that was certainly the experience for me.  If your experience is poor contact your union representative and let them advocate for you.

Examine any insurance policies that you have and check if you have any cover for critical illness.

If you have private health insurance, contact your provider and ask them to go over what exactly you are entitled to.

If you live in Ireland and you are not entitled to a medical card, get a Drugs Payment Scheme (DPS) card immediately as the cost of some medications are prohibitive. With the DPS card the maximum you have to pay is 144 euros a month.
There are social workers working on most oncology wards or at least there is access to one. It may be very useful to have a chat with them just to check exactly what to expect and what you may be entitled to. Another option is to attend your cancer support centre where some centres have people from citizens advice available to discuss and help with filling out tedious forms.

Keep a record of all your expenses and retain all receipts so that you can claim from revenue the following year.   In addition, if you have not claimed any tax for the previous four years you may be entitled to some tax back.

Many extended family members and friends want to help throughout  this difficult time. Take up any offers in a constructive way by asking for help with transport to and from the hospital; child-minding; cooked meals and maintenance tasks around the home.

On treatment days, consider bringing your own lunch and water. My experience of chemo days was that I didn’t know what I wanted to eat. Most times a packed lunch would suffice with snacks to help with nausea or cravings!

Lastly, if you find yourself in dire financial need, some charities offer financial assistance in the way of grants or help with household bills. A letter from your medical Consultant may be necessary.

Compared to when I was first diagnosed, there are resources available but the difficulty remains in not being aware of what is available for you.   A  diagnosis of cancer in a family is extremely harrowing and stressful but with the right supports; physical, psychological and financial, some of the burden may be alleviated.

Hope this helps..

Resources:

cancer.ie
welfare.ie
citizensinformation.ie
citizensadvice.org.uk
gov.uk.
Australian Department of Human Service

American Cancer Society

usa.gov/benefits

References
Brooks, J et al(2011) Additional financial costs borne by cancer patients: a narrative review. Journal of Oncology Nursing. 15(4) 302-10.
Matthews, M& Park, AD(2009) Identifying patients in financial need: cancer care providers perceptions of barriers. Clinical Journal of Nursing. 13(5) 501-5.
Mc Grath, P. (2017) Financial Assistance for patients who relocate for specialist care in Hematology: Practical findings to inform nursing supportive care. Nursing Forum. 52(1): 55-61.
Zucca, A et al (2011) Travelling all over the countryside: travel related burden and financial difficulties reported by caner patients in New South Wales and Victoria. Australian Journal of Rural Health. 19(6) :298-305.

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