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.