Financial and Legal Matters
Resources
Learning To Relax

Financial and Legal Matters

The financial challenges that people with cancer and their families face are very real. During an illness, you and your family may have found it hard to find the time or energy to review your options. Yet it's important to keep your family financially healthy.

For hospital bills, you may want to talk with a hospital financial counselor. You may be able to work out a monthly payment plan or even get a reduced rate. You may also want to stay in touch with your insurance company to make sure costs are covered.

For information about resources that are available, see the Resources section. You can also get the NCI fact sheet "Financial Resources for People with Cancer" at www.cancer.gov, search terms "financial assistance." Or call toll-free 1-800-4-CANCER (1-800-422-6237) to ask for it.

Legal Documents

If you haven't developed an advance directive, you may want to consider it. Advance directives are legal documents that let a person decide important issues ahead of time, including how much treatment to receive and who should make decisions if he or she can't. Having an advance directive helps ensure that you get the treatment you want. Understanding your wishes will also make it easier for family members if a time comes when treatment decisions need to be made.

Advance directives:

• A living will lets people know what kind of medical care patients want if they are unable to speak for themselves.
• A durable power of attorney for health care names a person to make medical decisions for a patient if he or she can't make them. This person, chosen by the patient, is called a health care proxy.

Other legal papers that are not part of the advance directives:

• A will tells how a person wants to divide money and property among his or her heirs. (Heirs are usually the surviving family members. Other people may also be named as heirs in a will.)
• A trust appoints the person a patient chooses to manage money for him or her.
• Power of attorney appoints a person to make financial decisions for the patient when he or she can't make them.

A lawyer does not always need to be present when you fill out these papers. However, a notary public may be needed. Each state has its own laws about advance directives. Check with your lawyer or social worker about the laws in your state. See the Resources section for more information.

Resources

Federal Agencies

National Cancer Institute
NCI provides current information on cancer prevention, screening, diagnosis, treatment, genetics, and supportive care. It also lists clinical trials and specific cancer topics in NCI's Physician Data Query (PDQ®) database. The following free material may also be helpful. To order, visit NCI's Web site or call NCI's Cancer Information Service (CIS) tollfree.

• Facing Forward: Ways You Can Make a Difference in Cancer
• Facing Forward: When Someone You Love Has Completed Cancer Treatment - Support for Caregivers
• Moving Beyond Breast Cancer (DVD or videotape)

Cancer Information Service
CIS answers questions about cancer, clinical trials, and cancer-related services and helps users find information on the NCI Web site. It also provides NCI printed materials.

Administration on Aging
The Administration on Aging provides information, assistance, individual counseling, organization of support groups, caregiver training, respite care, and supplemental services.

Centers for Medicare & Medicaid Services
The Centers for Medicare & Medicaid Services provides information for consumers about patient rights, prescription drugs, and health insurance issues, including Medicare and Medicaid.

Equal Employment Opportunity Commission
EEOC provides fact sheets about job discrimination, protections under the Americans With Disabilities Act, and employer responsibilities. It also coordinates investigations of employment discrimination.

National Association of Area Agencies on Aging/Eldercare Locator
The Eldercare Locator is a nationwide directory assistance service designed to help older persons and caregivers find local resources for support. Areas of support include transportation, meals, home care, housing alternatives, legal issues, and social activities.

U.S. Department of Labor/Office of Disability Employment Policy
The U.S. Department of Labor provides fact sheets on a variety of disability issues, including discrimination, workplace accommodation, and legal rights.

Nonprofit Organizations

American Cancer Society/National Cancer Information Center
ACS provides cancer information and support to patients, families, and caregivers. It also supports research, community education, and advocacy and public policy issues.

CancerCare
CancerCare provides free, professional support services to anyone affected by cancer: people with cancer, caregivers, children, loved ones, and the bereaved. CancerCare programs - including counseling, education, financial assistance and practical help - are provided by trained oncology social workers and are free of charge.

Cancer Hope Network
Cancer Hope Network matches patients and families with trained volunteers who have recovered from a similar cancer experience.

Family Caregiver Alliance
FCA addresses the needs of families and friends who provide long-term care at home.

Gilda's Club, Inc.
Gilda's Club provides social and emotional support for patients, families, and friends.

Lance Armstrong Foundation
The Lance Armstrong Foundation seeks to inspire and empower people living with, through, and beyond cancer to live strong. It provides education, advocacy, and public health and research programs.

National Coalition for Cancer Survivorship
NCCS provides information and resources on cancer support, advocacy, and quality-oflife issues to cancer survivors and their loved ones.

National Family Caregivers Association
NFCA provides information, education, support, public awareness, and advocacy for caregivers.

NeedyMeds
The NeedyMeds Web site lists medicine assistance programs available from drug companies. NOTE: Usually, patients cannot apply directly to these programs. Ask a doctor, nurse, or social worker to contact NeedyMeds on your behalf.

Patient Advocate Foundation
PAF provides education, legal counseling, and referrals to cancer patients and survivors. It specializes in matters related to managed care, insurance, financial issues, job discrimination, and debt crisis.

The Well Spouse Association
The association provides support to wives, husbands, and partners of chronically ill and/or disabled persons.

The Wellness Community
The Wellness Community is a national organization that provides support groups, stress reduction and cancer education workshops, nutrition guidance, exercise sessions, and social events.

Learning To Relax

Many people with cancer have found that practicing deep relaxation has helped relieve their pain or reduce their stress. The exercises on the next few pages may not be right for everyone. Ask your doctor or nurse if these exercises can help you. Before trying the full exercise below, first practice steps 1 through 5, so you can get used to deep breathing and muscle relaxation.

You may find that your mind wanders. When you notice yourself thinking of something else, gently direct your attention back to your deepening relaxation. Be sure to maintain your deep breathing. If any of these steps makes you feel uncomfortable, feel free to leave it out.

Exercise 1

1. Find a quiet place where you can rest undisturbed for 20 minutes. Let others know you need this time for yourself.
2. Make sure the setting is relaxing. For example, dim the lights if you like, and find a comfortable chair or couch.
3. Get into a comfortable position where you can relax your muscles. Close your eyes and clear your mind of distractions.
4. Breathe deeply, at a slow and relaxing pace. People usually breathe shallowly, high in their chests. Concentrate on breathing deeply and slowly, raising your belly, rather than just your chest, with each breath.
5. Next, go through each of your major muscle groups, tensing (squeezing) them for 10 seconds and then relaxing. If tensing any particular muscle group is painful, skip the tensing step and concentrate just on relaxing. Focus completely on releasing all the tension from your muscles and notice the differences you feel when they are relaxed. Focus on the pleasant feeling of relaxation.

   In turn, tense, hold, and relax your:

   • Right and left arms. Make a fist and bring it up to your shoulder, tightening your arm.
   • Lips, eyes, and forehead. Scowl, raise your eyebrows, pucker your lips, and then grin.
   • Jaws and neck. Thrust your lower jaw out, and then relax. Then tilt your chin down toward your chest.
   • Shoulders. Shrug your shoulders upward toward your ears.
   • Chest. Push out your chest.
   • Stomach. Suck in your stomach.
   • Lower back. Stretch your lower back so that it forms a gentle arch, with your stomach pushed outward. Make sure to do this gently, as these muscles are often tight.
   • Buttocks. Squeeze your buttocks together.
   • Thighs. Press your thighs together.
   • Calves. Point your toes up, toward your knees.
   • Feet. Point your toes down, like a ballet dancer's.
6. Review these parts of your body again and release any tension that remains. Be sure to maintain your deep breathing.
7. Now that you are relaxed, imagine a calming scene. Choose a spot that is particularly pleasant to you. It may be a favorite comfortable room, a sandy beach, a chair in front of a fireplace, or any other relaxing place. Concentrate on the details:
   • What can you see around you?
   • What do you smell?
   • What are the sounds that you hear? For example, if you are on the beach, how does the sand feel on your feet, how do the waves sound, and how does the air smell?
   • Can you taste anything?
   • Continue to breathe deeply as you imagine yourself relaxing in your safe, comfortable place.
8. Some people find it helpful at this point to focus on thoughts that enhance their relaxation. For example: "My arms and legs are very comfortable. I can just sink into this chair and focus only on the relaxation."
9. Spend a few more minutes enjoying the feeling of comfort and relaxation.
10. When you are ready, start gently moving your hands and feet and bringing yourself back to reality. Open your eyes and spend a few minutes becoming more alert. Notice how you feel now that you have completed the relaxation exercise, and try to carry these feelings with you into the rest of your day.

Exercise 2

1. Sit comfortably. Loosen any tight clothes. Close your eyes. Clear your mind and relax your muscles using steps 4 and 5 above.
2. Focus your mind on your right arm. Repeat to yourself, "My right arm feels heavy and warm." Stick with it until your arm does feel heavy and warm.
3. Repeat with the rest of your muscles until you are fully relaxed.

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