Cheryl Hughes, Licensed Clinical Social Worker, MedStar Georgetown University Hospital

It’s never easy to deal with a loss, but the holiday season has a tendency to bring up painful reminders of deceased loved ones. And this year, many Americans may be dealing with grief over the holidays for the first time, as we mourn family and friends who lost their lives to COVID-19. It’s not just death that can cause grief over the holidays. In fact, it’s likely that most people are coping with a variety of losses this year, from the loss of a job to a loss of a relationship as a result of being geographically distant or feeling isolated from people they love. Click to Tweet Starting around Thanksgiving, many people who have lost loved ones experience sorrow as they’re reminded of memories from those who are no longer near. Holiday traditions meant to bring joy, like trimming the Christmas tree or listening to holiday music can trigger feelings of intense grief as we remember holidays past and wonder how to celebrate the festive season without the people we love. Grief is complicated and looks different for everyone. Sometimes, it’s surprising. Whether your loss is fresh or you’ve lost someone decades ago, unexpected feelings of sadness and loss can surface that aren’t necessarily attached to a specific memory. For some, these moments of grief can appear out of nowhere. For others, grief over the holidays is expected and dreaded. This year, the public health crisis that has affected all of us in different ways may result in added grief on top of an already emotionally-loaded time of year. There’s no right way to grieve, but there are things you can do to try to cope over the holidays while acknowledging and expressing your sadness. The holidays can generate exaggerated feelings as the pressure to “be merry” collides with the reality of our grief. Grief can present itself in a variety of emotions, from sadness or anxiety to irritability or anger. Everyone grieves differently. But that can be difficult when you’re around family members who expect you to show sadness in the same way—or even hide it. But, you’re human and allowed to feel a wide range of emotions, including both grief and joy. Sometimes you may even feel happy and sad within a few minutes. It’s healthy to acknowledge your emotions and accept how you’re feeling rather than try to escape it. It may sound simple, but self-care is one of the best ways to deal with grief over the holidays. Think about how you would care for others in your life experiencing loss, then apply the same measures of compassion and grace to yourself. When grief hits hard, try to find things to do that help you to feel supported and restored, whether that means getting outside for some exercise, meditating, or journaling about someone—or something—you miss. One way to deal with grief over the holidays is to memorialize the legacy of someone you’ve lost and keep their memory alive. Whether you incorporate them into existing traditions or establish new celebrations, it can be therapeutic to remember the lives of those who’ve died. Here are a few ways you can honor the life of loved ones over the holidays: Set a place for them at the table Tell stories about them related to the holidays Create an altar with favorite pictures and mementos Write them a letter or email Prepare a lost loved one’s favorite holiday dish Light a candle in their memory Experts know that grief needs to be heard and witnessed. Try to find someone who you know is a good listener and admit to them when you’re having a hard time. Healing can begin when we’re able to speak our grief into existence. And, when you’re in the listener’s role, remember that it’s not up to you to fix it. There’s no fixing grief. Instead, listen without judgment and remember that anything they’re feeling is okay. This is especially true for parents of kids who may also be grieving. Kids need permission to feel all kinds of emotions, even if their grief manifests differently than yours. If you can help them normalize their feelings, whether that’s joy amidst sorrow or guilt coupled with happiness, you can help them to work through the grieving process in a healthy way. If you don’t have anyone to talk to, or you’re experiencing overwhelming grief for weeks or months, it may be helpful to seek counseling services from a therapist or psychologist. It’s healthy to ask for support, even if it’s outside of your inner circle. A professional counselor can serve as an active listener who can help you find healthy ways to cope with your grief, especially over the holidays. Whether your grief is new this holiday season, or you struggle with sadness this time every year, know that you’re not alone. And, those feelings won’t last forever. While the holidays may never feel the same, time and support can help you to make it through to the New Year a little bit easier. Learn More

At every stage in your journey with cancer, you are likely to have uncertainties or worries. Your doctor can help to allay some of these fears and let you know the impact that cancer treatment may have on your life. But it’s important to communicate your questions and concerns, so your treatment team can be focused on the things that are most important to you. Before your next appointment, think about the following topics and use them to decide what questions you want to ask. What Is Important to You? Your doctor wants to help you have the best quality of life you can while undergoing treatment for cancer. Your treatment plan is one of the most effective ways to achieve this goal. These plans generally include regular appointments with your medical team. However, sometimes these appointments may become narrowly focused on your treatment and prognosis. You may find that you’re worried about other aspects of your life that are impacted by your treatment. It’s important to discuss these issues with your treatment team, and let them know what is important to you. For example, you might find that the thing that upsets you most is not being able to coach your child’s soccer team, in which case you should ask your doctor whether there is any way you can alter your treatment to give you the time or energy to return to coaching. Or perhaps you have planned a vacation, and don’t know whether it will be impacted by your treatment schedule. Although some treatments are time-sensitive, others can be safely delayed or adjusted to accommodate your needs. Rather than assuming you have to give up the things that bring value and meaning to your life due to your cancer – ask your doctor whether they can remain part of your life. Your doctor will be able to discuss the risks and benefits of various activities and treatments with you, so you can make the decisions that are right for you. Doctors are keen to help you live a full life, even when you have cancer, but they won’t know what is important to you unless you let them know. Are There Questions You Are Embarrassed to Ask? Are there questions you have been putting off asking your doctor out of embarrassment? Your doctor has likely heard these questions before and won’t be shocked or surprised by them. If, for example, you want to know whether you can still have sex during treatment, or whether it is normal for your treatment to cause sexual side effects such as dryness, lack of libido or problems with erections, go ahead and ask. Your doctor can deal with these and other personal questions sensitively and professionally. Recording Your Doctor’s Answers to Questions Time with your doctor is precious. It’s common for patients to forget what questions they want to ask, as well as forgetting the answers the doctor gave. Write your questions down and bring the list with you so you don’t have to worry about remembering them. You might also find it helpful to bring another person to the appointment with you, so you can listen to the doctor while your friend or family member makes notes. Another option is to use your cell phone to record the doctor’s answers. You should always ask permission before you start recording, but generally doctors are comfortable having patients record discussions. Maintaining open lines of communication with your medical team helps to ensure that your goals align with those of your medical team to provide you with the treatment plan that best suits your particular lifestyle and needs. Below, find a printable pdf of additional suggested questions to ask your doctor:

One of the first thoughts many patients have after learning they have cancer is, “How do I tell my children?”At first, you may be inclined to avoid the question altogether. This is understandable; you need time to understand the reality of your diagnosis and process your thoughts. And sometimes, your instinct to protect your children from sadness and stress can override the desire to help them prepare for the realities of the situation.But discussing your cancer with your family is an important conversation to initiate. And believe it or not, just talking about your cancer can reduce stress while providing your children with the necessary information to help them adjust in healthy, age-appropriate ways.Why You Need to Talk About Your DiagnosisMany patients believe it’s better not to discuss a cancer diagnosis with young children. They worry that the children’s lives will be so negatively impacted that it’s better to pretend that life is continuing as it always has.However, try as you might to hide your diagnosis, children can pick up on the pulse and tone of daily life in your family - and that includes the stress or anxiety you may be feeling about having cancer.For example, your child may notice that their grandmother is visiting more often than usual, they are spending more time in childcare, or you are too tired to play the way you used to. When young children detect nuances within the home but are not informed about why things have changed - no matter how subtle the changes may seem - they quickly come to their own conclusions (which may be worse than the reality).So even though you try to minimize their exposure to difficult emotions, children generally know that something is wrong.They Need to Hear It From YouChildren are great listeners, and often they overhear friends or family members talking in hushed tones about a parent’s illness. Or sometimes, well-meaning family members may talk to your child about your diagnosis before you’ve had a chance to clarify the situation. Talking to your children can avoid the possibility that they will learn about your diagnosis and treatment from someone else, which could impact your relationship with your child, and may lead to loss of trust.A conversation like this is never easy. However, when children are provided with age-appropriate information about the disease, an understanding of how your treatment will impact their lives, and the ability to ask questions, they gain awareness of the healthy ways that families come together to support one another during difficult times.Adult children, too, need to be considered. They may want to be involved in helping to support you through your treatment. Your kids will want to care for you. They will want to express their worry, as well as their love and care. Not telling your children about your cancer prevents them from acting on their concern for you and your health.When your friends and family understand your diagnosis, your treatment options, and what cancer will mean for you, they will be better prepared to comprehend what it will mean for them as well. By talking about your cancer, you may be able to avoid adverse emotional outcomes and gain the family support you need.How to Start the ConversationDeciding when to have this discussion with your children is almost as important as what you say. In general, you may want to avoid times when your child is tired, stressed or hungry, or when you may be interrupted. If your family includes children of various developmental stages, you may want to tell the older children first, then allow them to take part in the conversation you have with younger children.As you prepare for your conversation, keep the age of your child(ren) in mind. Because children – even children in the same family – develop at their own pace, determine in advance how to approach this discussion. Very young children (ages 3 to 6 years old) may be satisfied with generalizations, but older children may want specifics and an outline for a plan.Along with thinking about your child’s age and developmental stage, you’ll also want to consider your child’s temperament. While some children’s anxiety is eased by your state of calm, others may need additional information and/or frequent check-ins. Even siblings can respond differently to the same information.Tailor your conversation to the needs of your child. Some children will be reassured by more physical contact with you; others may need to have activities to help them process the information. Let your children know that any feeling they experience is okay, and that they can come to you with any questions they may have.In this way, you can provide a positive forum for your children to develop their own set of emotions around your diagnosis, while letting them know they are a part of a family that works together to manage difficult problems and situations.If you can only focus on the basics, the following three points are most important for children to understand:First, let your children know that cancer is not their fault. It’s not anyone’s fault; it just happens. It’s common for young children (ages 4 to 12 years old) to engage in “magical thinking,” therefore believing that they somehow caused the cancer to happen. Reminding them that cancer is no one’s fault can help them come to understand this.Cancer is not contagious. It’s not like a virus, the flu or a cold.And finally, let your family know that it's safe to ask any questions about your diagnosis.Explain what your diagnosis might mean in your family’s daily life. For example, while you may be actively involved in your child’s favorite activities, you might not be able to have the same level of involvement during treatment. Clarify that you always want to be with your child to support the activities they love, but that you will need to do so now in a different, quieter way. Perhaps rather than coaching your child's soccer team, you observe and take stats.Explain to younger children that the cells in your body are doing things that may make you more tired than usual so you won’t be able to play outside right now. So instead of rough housing, maybe you can read a book or watch a favorite movie. Children will appreciate knowing how your cancer treatment will affect them. And you can reassure your children – and yourself – that your cancer diagnosis doesn’t mean sacrificing quality time together.Finally, if you have adult children, allow them to be a part of your journey by helping you. For example, your adult children can provide transportation, grocery shopping, meals or quiet, supportive conversation.Final ThoughtYour cancer diagnosis might be a shock that feels uniquely yours alone, but it also affects your family and friends, and that includes your children. When you are aware of your cancer diagnosis but your children aren't, you might be leaving them in the dark about a life-altering event. The one factor to remember when talking to your family about your illness is to keep the lines of communication open.One sure way to reduce the stress of your circumstances, your children’s fear of the unknown, and anxiety about your diagnosis is to provide an age-appropriate explanation for your cancer, and look for ways your children can actively support you. For more information about this topic, check with the American Cancer Society or the Cancer Support Community. Both of these organizations offer online publications on helping children when a parent has cancer.In addition, your oncology social worker is a great resource for these and other difficult situations that arise when undergoing treatment for cancer.