There are two broad moves that all caregivers can make so that life goes as smoothly as possible when a loved one has cancer—and these acts may be especially important for gay and lesbian caregivers. Briefly: You should call on family, friends, and community for help with the avalanche of responsibilities that may fall on your shoulders; and you should have clear legal authority to act on behalf of the person who is ill.

Call on Your 'Family of Choice'

To anyone who has cared for a seriously ill person, it will come as no surprise that it can be a burn-out job if you try to go it alone. Caregivers help the cancer patient navigate the medical system; they provide emotional support, meals, and rides to doctors' appointments, pick up prescriptions, and fill a dozen other needs—all while their own feelings may swing between fear, sadness, resentment, love, and exhaustion.

And same-sex couples may not have as much support as they could use from biological family members—either their own or their ill partner's. If this is the case, it's important for a caregiver to draw on trusted friends or what some in the lesbian, gay, bisexual, and transgender (LGBT) community call a "family of choice."

In a talk show on the Society's Cancer Survivors Network, Susan, a lesbian caregiver, recalled how important friends became when her life partner began treatment for colon cancer at age 45, and she gradually became overwhelmed herself. "I learned that first you do have to take care of yourself, and secondly, you shouldn't be afraid to ask other people for help," she said.

"I think that it's extremely important . . . that we turn to that extended family," Susan continued. "That group of people that we've created as family, and really act with them like we would with family. Meaning, go ahead and act, don't worry about inconveniencing them. Just say it, 'This is what I need. I need your help.'"

'Here's What You Can Do'

When people offer to help, it's a good idea to be ready with specific requests. These links offer tips on tasks and roles that can be delegated to different people.

The Organizer—Help the person with cancer plan treatment schedules, transportation, child care, and record-keeping.

The Emotional Supporter—Provide comfort and encouragement, listen, relay information to a circle of friends and family, help find a support group.

The Patient Advocate—Help with second opinions, treatment decisions, insure that pain or other side effects are promptly treated, and more.

Concrete Ways to Help—Help with meals, rides, taking phone calls, organizing a blood drive and more.

Resources for LGBT Caregivers

Gay and Lesbian Cancer Discussion Boards, Cancer Survivors Network
Titles include "Gay Men Talk About Cancer," "When Your Partner Has Cancer" Lesbians Speak Out"

LGBT Frequently Asked Questions, Family Caregiver Alliance
Topics include finding a good care provider, sharing parent care among siblings, the Family and Medical Leave Act, and more.

The Mautner Project

Get It in Writing: Important Legal Documents

In general, same-sex relationships are not recognized by US courts, and the laws and rights that apply to married couples don't always apply to domestic partners. So biological family members can theoretically take control over medical and financial decisions for an LGBT person who is ill . . . possibly even preventing that person's partner or close friend from being involved.

While that type of extreme situation is unlikely to occur, a family conference, along with proper documentation, can prevent smaller misunderstandings and arguments about care for the person with cancer. Hospital social workers, support group leaders, or hospice care managers may be able if needed, to lead a family conference with the sick person's chosen and biological family members.

The LGBT person with cancer should also have legal documents created to give his or her chosen family the authority to act on his or her behalf. Those documents can include a durable power of attorney for health care, and some type of advance directive like a living will or a do-not-resuscitate-order, which establish in writing what kind of care that person prefers if he or she becomes too sick to make medical decisions.

The Lambda Legal organization may be able to provide more information on advance planning for LGBT individuals.

If health care professionals seem insensitive or don't include an LGBT person's caregiver in their discussions, the simplest approach is for the person with cancer to speak directly with the doctor or nurse—but there may also be a hospital or clinic ombudsman who can help with the situation.

Susan, the CSN member quoted above, recalls that clear communication from the beginning prevented any problems. "Sheryl was very clear with people that I was her life partner and that anything that they wanted to tell her they could tell me and we were making decisions together."