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DS12
Posts: 1
Joined: Aug 2014

Good afternoon all. I want to thank everyone from what I can see after just joining this CSN about 15 minutes ago is a place full of amazing people faced with so much but still managing to help strangers on the Internet they'll never meet.

My father has pancreatic cancer. He was diagnosed 2 years ago at the age of 50. Since then, he has had chemotherapy, radiation, and an ex-vivo radical surgery to resect the tumor (but in the process he also had his stomach removed). 

He has had depression and anxiety his entire life, long before the cancer, but as you can imagine, being faced with such a terrible illness and the delibitating effects of treatment has made his depression and anxiety even worse. 

He was given a small dose of antidepressants while in the hospital several months ago but has recently declared that he has made the decision not to take antidepressants anymore. He refuses to see a mental health professional and refuses to take any antidepressants. However, he routinely makes passive suicidal statements, such as how he doesn't want to live anymore, he can't take it anymore, etc. While absolutely no one in my family questions why he feels this way, judges him, or believes he is in the wrong for feeling this way, his depression for which he refuses to get treatment is taking a serious emotional toll on everyone. My brother, who has significant psychiatric disabilities, has especially been impacted, and been hospitalized for his own suicide attempts because of the home environment. 

I know no one can force my father to take medications or see a mental health professional, but my question is, are there any resources out there? Case managers? Social workers? Someone to help my family? We are in crisis. If my father does not want to live, then I suppose palliative care/hospice is the only option, but how do I get that? I feel like we are so adrift and alone. He has various doctors but his care seems very compartmentalized and I just don't know who to turn to or where to go. I've heard of something called a case manager that makes an assessment on the patient and family and can help coordinate and obtain community resources, etc. But I dont even know where to begin.

If anyone has any kind of experience with case management, obtaining resources, etc, I would greatly appreciate your help. Frankly, I just don't know how to proceed. I don't want my father OR the rest of my family to suffer any more than we already have.

Thank you for your time

kpsocial
Posts: 1
Joined: Sep 2014

DS12 This is indeed a very difficult situation because he's in a grey area (in other words not immintently or actively suicidal yet tettering on the edge).  I would call and ask your fathers' most trusted cancer provider whom can help with this.  His medical facility may have social workers or you can also try looking up mental health resources by county, or doing a good search for mental health providers in some community clinics or maybe try asking the mental health professional that cares for your brother??? If your father isn't okay with taking psychiatric medications perhaps he would agree just to talking to a talk therapist?  A therapist can assist with monitoring his suicidality and helping to set limits/boundaries so that his mood issues are not effecting the family so much.  Hope this helps, I really feel for you.

Hussy
Posts: 11
Joined: Jun 2014

Please call the Pancreatic Cancer Action Network and speak with a Patients and Liaisons Services (PALS) associate.  Here is the link to their toll free number. 

http://www.pancan.org/section-facing-pancreatic-cancer/oneonone-support/

They can help you with many of your questions. 

With no disrepect to kpsocial,  I don't think any of us here are qualified to make the call that your father is or is not actively suicidal.  That is something that only a qualified professional can determine. 

I don't know where your father is being treated, but generally speaking your treatment center should have a whole spectrum of resources you and your father can access  -- and usually you can request the services of a case worker (to help you with insurance issues and find resources) and a clinical social worker, who can speak with your father or you (or both).  I think it would good for you to speak with someone for your own well-being because I sense that you are feeling the pressure to "save the day" -- to take care of not only your father but your entire family.  And that's just too much pressure to put on one family member.  You need to take care of yourself in order to be there for someone else. 

Tell your father's oncologist that he is expressing suicidal thoughts and ask him to schedule a mental health evaluation by a psychiatrist.  Also ask for a referral to a palliative care doctor.  Ask about hospice.  You should not have to do a search on your own for these resources.  The treatment center should be able to point you in the right direction.  Be persistent. 

Good luck and please let us know how you are doing.

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