Domestic violence and caregiving

October is a month dedicated towards raising awareness for a variety
of things, including breast cancer and domestic violence.

Intimate Partner Violence (IPV), more commonly known as domestic
violence, can happen to anyone. It affects all races, ages,
educational levels, socio-economic classes, genders and sexual
orientations. Domestic violence describes emotional, psychological,
sexual, or physical abuse by an intimate partner. These abusive
behaviors are aimed at maintaining power and control over a partner,
and may be hard to recognize at the beginning of a relationship. 

Abusive behaviors present in domestic violence tend to escalate over
time, and intensify during significant life events where reliance on a
partner increases, such as receiving a cancer diagnosis. This becomes
a particularly sensitive time, as spouses, partners or significant
others often also become the primary caregiver, which then increase
their involvement with the patient’s physical, emotional and financial needs.

Signs of cancer-related domestic violence

After a cancer diagnosis, it is common for patients to become more
reliant on an intimate partner. This shift can be particularly
stressful for all involved since it requires adjusting to a new
normal. However, there are some red flags to watch for.

For instance, the caregiver may:

  • Respond to the patient’s cancer diagnosis in a self-centered,
    minimizing or even dismissive way (e.g., they focus on how the
    diagnosis is affecting them and look for sympathy from others).
  • Not acknowledge the patient’s fatigue and/or increased need for
    rest. The caregiver may purposefully wake the patient from naps,
    prevent resting and/or assume that patient can resume normal
    household chores before fully recovering from treatment.
  • Make negative comments about changes in the patient’s appearance
    during treatment and/or after surgery.
  • Force the patient to
    consent to a treatment that is not wanted or deny treatment that is
    wanted/needed.
  • Deprive the patient of medications or
    communication devices.
  • Use the cancer diagnosis as a reason
    to prevent the patient from interacting with loved ones.
  • Exclude the patient in financial decisions that relate directly
    to the patient’s income.

If some of the examples above sound familiar to your relationship,
know that you are not alone – and that you are not to blame. There is
never an excuse for abuse. No one deserves to be in a relationship
where their emotional and physical safety is in danger.

Safety planning

If you feel that you’re in emotional or physical danger, it’s
important to think ahead about what steps to take. This is called
safety planning. Keep in mind that safety looks different for
everyone. It can include how to stay safe while living with an abuser,
while planning to leave, or taking steps after you have gotten out of
the situation. No matter what stage you are in, remember that you have
options and are not alone.

If it feels safe to do so, let someone you trust on your health care
team know what is going on. They may be able to help update emergency
contact information and/or complete Advance Directives, which allows patients to
designate a health care decision maker. Also, you may want to speak
with your medical provider about what type of information you feel
comfortable having in your medical record since your caregiver may
have access to view your medical records. 

If you have additional questions, need assistance with creating a
safety plan and/or emotional support, please contact your MD Anderson social work counselor by calling
(713) 792-6195. You can also get help or learn more by calling The
National Domestic Violence Hotline at 1-800-799-7233 or 1-800-787-3224
(TTY), or by chatting with advocates online.