No matter your circumstances, a diagnosis of non-small-cell lung cancer (NSCLC) is scary. But if you’re a senior who lives alone, like Sue Balcom of North Bismarck, North Dakota, you may feel particularly overwhelmed and worried.
“With this disease, there’s just so much that you’ve got to deal with every day in every way,” says Balcom, 70, who has stage IV NSCLC.
Fortunately, as Balcom has found, many resources exist to help you manage living solo during treatment.
Day-to-Day Challenges
NSCLC will make it hard to do the things that you normally do every day. These include chores such as shopping, cooking, and cleaning.
“NSCLC and its treatment can cause various side effects, such as fatigue, weakness, and shortness of breath, that can make everyday tasks feel more difficult,” says Mae Ryan, a licensed master social worker and an outpatient social worker who specializes in lung cancer at Mount Sinai Hospital in New York City.
And, Ryan adds, treatment side effects such as fatigue can combine with balance problems that often come with age. This, she says, can make it harder to move around the house safely, get yourself to and from appointments, and more.
Right now, when you’re newly diagnosed, is the best time to think and talk about how to approach daily living.
“We really like to start conversations about this early,” says Katie Johnson, an oncology nurse at Fred Hutch Cancer Center in Seattle, Washington.
Where to Start
Remember: You may live alone, but you are not on your own. You will have help. A key part of this early on will be connecting with a palliative care team.
Johnson says that people sometimes mistake palliative care for hospice.
“They are a layer of support that allows the patient to think through questions and concerns early,” she says.
One essential service they provide is home-based care.
“What the team can do is assess the safety of your home,” Johnson says.
These specialists can also help you manage symptoms, medication side effects, and other medical concerns. Additionally, they help coordinate medical care and social services you may need, including financial help and government programs that can offer assistance.
“We always recommend home-based palliative care,” Johnson says.
Balcom agrees.
“My palliative care nurse was a wealth of information for support,” Balcom says. She says her palliative care nurse set her up with the person who evaluated her own home for safety concerns.
Changes to Your Home
Fatigue, mobility problems, weakness, and more make falls more likely, Ryan says. But adjustments to your home can help keep you safer. Your palliative care team can help assess your needs, as can home health specialists, such as social workers and nurses, Johnson says.
Your needs will depend on your living situation, but some common adjustments include:
- Removing loose rugs
- Improving lighting to make navigating your space easier
- Installing grab bars in the bathroom
To conserve energy while cooking, Ryan suggests buying lightweight pans and moving a chair into the kitchen, in case you need a break.
In your bedroom, she says, keep nighttime medications, your alarm clock, and a lamp within arm’s reach of your bed.
In addition to home safety, resources are available to keep your house clean. Balcom says her health care team hooked her up with a free housecleaning service. Ask your provider if such services are available in your area or contact cleaningforareason.org, a housecleaning service for cancer patients.
Supplemental Oxygen Concerns
If you need supplemental oxygen, a member of your medical team can assess your home to figure out the best place for your equipment. Ryan says some considerations are particularly important:
- Have a space prepared to keep your equipment that’s at least 10 feet from heat sources (such as your oven), flammable materials (such as gas, oil, and rubbing alcohol), and electrical equipment (such as hairdryers and space heaters).
- Set up your equipment to minimize tripping hazards. For example, the tubing should be kept out of your hallways.
- Consider portable oxygen options that allow you to take your oxygen out of the house if necessary.
Let Tech Help
These days, Balcom never goes anywhere without her phone.
“Once I started thinking of all the things that could happen, it became my best friend,” she says.
For example, if she falls, she has her phone close at hand and can call for help. One of her counselors has encouraged her to consider using a smart watch, such as an Apple Watch. Ryan recommends similar devices as well.
“Health tracking devices, such as Apple watches, have medical alert functions that can detect safety concerns, including fall detection,” she explains. If you do fall and can’t use your phone, such devices can send alerts to your emergency contacts and emergency services. Your care team can recommend the right device for you.
Ryan also recommends tech that makes life easier, including:
- Online grocery and pharmacy delivery services, such as Instacart
- Online calendars, such as Google Calendar, to manage appointments, set reminders, and share your schedule with family and caregivers
- Telehealth platforms that use services such as Zoom, which allow you to see your provider online so you don’t have to travel to your doctor’s office
Assembling a Support Team
You will need assistance along the way. Family, friends, and others can get you to appointments, help around the house, and run errands for you when needed. Identifying people in your life who can lend a hand is an early priority.
“Just having two or three people is really great,” Johnson says. “That way you don’t feel like you’re putting too much on one person.”
Family members can be excellent sources of assistance but not for everyone. If you don’t have family available to help, consider other options, such as your neighbors and, if you’re a churchgoer, members of your church community.
If you don’t have obvious sources of support, reach out to your oncology social worker.
“They can talk with you about your social structure and how it can be built up to support you,” Johnson says.
Explore the resources available through national organizations that offer free services, including educational materials, patient and caregiver support, and in-person and virtual events, Ryan says. These include:
“LUNGevity’s lung cancer helpline connects patients with a lung cancer navigator who can help patients explore local resources and manage financial challenges,” Ryan says.
Balcom, who has been living with lung cancer since 2023, says her palliative care nurse introduced her to a regional support group that she talks with online. She says that’s been essential for her emotional health.
“I would so encourage everybody out there, particularly if you’re living by yourself, to join a support group specifically for cancer because the only people that truly understand your feelings and the thoughts you have and the fears that you have are other people in your situation,” Balcom says.
Preparing an Emergency Action Plan
If something unexpected happens, you or the people around you need to act fast. That’s where having an emergency plan comes into play.
“Even a basic plan can make a meaningful difference,” Ryan says.
Information that should be easily accessible:
- Emergency contacts, such as the contact information of your caregivers, primary oncologist, and other health care providers
- Medical information, including your diagnosis, allergies, medications, and pharmacy details
- Advance care directives that include your health care proxy (who’s empowered to make medical decisions when you’re not able to) as well as your wishes regarding the type of life-sustaining care you do or do not wish to receive, such as cardiopulmonary resuscitation (CPR) and intubation
Ryan recommends you have ready a small “go bag” that holds the following:
- Your medication list
- A few days’ supply of medications
- Your ID
- Your insurance card
- A phone charger
- Basic personal items, in case you need a hospital stay
Ryan also suggests you discuss your plan with your care team and your caregivers. Practice your plan so your caregivers know what to do.
What Experts Want You to Know
Johnson and Ryan both recommend that you discuss and evaluate your needs with your care team right after your diagnosis. It is also essential to reevaluate your needs once in a while to determine whether they have changed. For example, if your energy levels decline, you may need more help around the house. For best results, be open with your care team about your needs.
When to Reconsider Your Living Situation
Lung cancer typically progresses, getting worse over time, Johnson says. Eventually, you may not be able to live alone safely. Johnson says how well you respond to treatment is a major factor that decides this.
If your lung cancer stops responding to the first treatment you were prescribed, your doctor will switch you to a second line of treatment. Johnson says such treatments typically come with more serious side effects, including:
- Dizziness or a major fall risk
- Constant hunger
- Poor sleep
“Once we start seeing those symptoms, we’re going to be concerned about your safety,” Johnson says.
Another indication that it’s time to consider a move is if hospitalization becomes more frequent.
“If you had to go to the hospital two or three times in the last two months, living alone may not be sustainable for you,” she says.
What are your options?
Where you may live will depend on your needs. If you require short-term care after you leave the hospital, for example, your doctor may recommend one of the following:
- Inpatient rehab to help you regain strength and enable you to live on your own once more
- Skilled nursing facilities, which provide around-the-clock care
Longer-term living options include:
- Nursing homes, if you need help with your daily activities but don’t need regular care from a doctor or nurse
- Assisted living facilities, which help you live independently in many ways but have staff to help with your medications, meals, and other daily needs
Medicaid, Medicare, private insurance, and the Veterans Administration (if you’re a veteran) offer some coverage for these types of care. You don’t have to figure this out on your own.
“I would recommend reaching out to your care team to explore the programs available to you in your area or through your hospital,” Ryan says. “They are often very knowledgeable about available resources. I encourage you to lean on all these available sources of support and resources. You do not need to be alone in this process.”
