We need to talk about Financial Toxicity
What is "financial toxicity"?
This is a term from medicine - in particular cancer treatment describing the additional problems that a patient may experience due to the cost of medical care. This can include:
- not having appropriate medical insurance
- debt and bankruptcy because of not being able to work (due to hospital visits/medical appointments - and the travel costs in getting there)
- needing care which can impact on the carer not being able to work
...and this can impact not just the quality of life for the person who is already having to battle a horrible, and sometimes chronic illness, but worse, affects the treatment.
Due to spiralling costs, patients have been known to
- skip appointments
- take lower dosages of medication, or skip dosages because of affordability
...and this can sometimes be recorded as "non compliance" or "nonadherence" to medical advice!
Ultimately, illness doesn't care if you have stopped taking treatment because you feel worse or because you cannot afford it, and tragically the outcome is often the same.
What is currently being done?
With most of the research from the US and based around cancer care - as this recognised as the most expensive treatment (eg: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4523887/) some of the key ways to address it include:
- Raising awareness:
a) Having the conversation about finances with the patients
b) Educating practitioners on the subject and the impact on behaviour
c) Highlighting it as an area that needs to be address for treatments to be successful
- Collaboration between practitioner and patient
a) An open exploration of the efficacy of all treatment options
b) Raising it as a question rather than assuming obstinate "non compliance"
c) Signposting to financial support available
a) Diagnosis as early as possible
b) Healthy practices to try to avoid the onset of illness - where possible/appropriate
c) Improving access to the support available
d) Encouraging people to be aware of financial bottom lines and fell comfortable discussing finances
Money talks but we don't
I know the goriest details of some of my friends' sex lives, but I don't know how much they earn. There is a HUGE taboo around the subject of money, and while of course it may be (is!!) wholly inappropriate as dinner conversation, we do need to get a bit more comfortable talking about money.
Why? Because sometimes, when we don't talk about it, it may be so uncomfortable that we don't really think about it either...and we DO need to be aware of it.
As one of the most common issues clients see me about is moving jobs, one of the main things we look at is "The Financial Bottom Line"
How much do you need to get by at the standard to which you are happy?
How long can this be sustained?
Within this we also explore priorities, and what is of value to the person - ie things they are not willing to cut back on. As difficult as it is, you do need to be honest here. If you "absolutely won't compromise" on, say, having a weekend break every 4 months - then that simply needs to be added into your budget. I'm not just looking at cost here, I'm looking at VALUE. (...and for some people that break is the respite needed in order to keep calm and carry on, for others it may be something else - YOU know what's essential for you.)
The cost of living crisis has affected everyone, and those who are managing illness moreso. It is further compounded by businesses closing resulting in job losses, and thus more competition for the work that is available.
There are a number of "hardship funds" available, along with people who can support with applications. In the Northampton community the following exist:
1. If you are a UK resident - you can apply for a hardship grant: https://www.foodaidnetwork.org.uk/hardship-funds BUT, you often need an organisation to refer you - such as the Citizens' Advice Bureau: https://www.northamptonshire.gov.uk/councilservices/children-families-education/service-finder/advice-and-support/890-citizens-advice-bureau-northampton They can also refer to things like food banks should this be necessary.
2. Within Northampton itself there is "Charity Link" https://charity-link.org/contact-us/ they can provide advice as well as support to apply if you are struggling
3. Homestart is an excellent charity who can give you support with filling in forms and so on https://www.home-start.org.uk/Pages/Category/things-we-can-help-with - so if you email them https://www.home-start.org.uk/home-start-northampton they can point you in the right direction, and actually go with you to any meetings and so on.
4. Help paying the rent can be found through the council - if you fill in an application form on their page: https://www.westnorthants.gov.uk/claiming-benefits/apply-discretionary-housing-payment - this works as an "emergency fund"
Casual work options
- Perhaps you can put a "looking for work" post up on local facebook groups in case they have anything casual going bearing in mind your own limits - whether as a carer or as a patient.
- Can you sell anything if you need cash immediately? Be mindful of online sales as sadly, when there is need there are also scammers, but that can be a short term option.
- Are other members of the family able to help with savings?
(I would not suggest short term loans due to the interest and other commitments)
Other useful links
- https://www.stepchange.org/ (to manage debt)
- https://www.mind.org.uk/ (for mental health support)
But also, and I realise this can be so difficult, every little thing that makes you feel a little bit better can help. There are wonderful charities out there providing companionship, activities, respite, warm space including these in the Northamptonshire area:
- The Lewis Foundation: https://www.thelewisfoundation.co.uk/ who provide care packages (essentials and meeting other needs) to adults battling cancer, as well as spending time in hospital to chat
- The United African Association:https://www.uaassociation.org/ they offer warm space and activities every Saturday as well as a food bank and support with other administrative needs
- The Hope Centre: https://www.northamptonhopecentre.org.uk/ support for those who are homeless including training, help with administration alongside the essentials of personal care
- The SYCC: https://sccyc.co.uk/support-and-poverty-services/ they have a food bank, they engage with community outreach as well as offer support and poverty services
- Homestart: https://www.home-start.org.uk/home-start-northampton services include respite if you need to make medical appointments
Battling illness is tough enough without the added pressure of financial toxicity making things worse.
Dr Audrey Tang is a chartered psychologist and author with a specialty in the practical "how to take action", rather than just giving explanation and advice. Listen to her podcast Retrain Your Brain here; or her Radio Show "The Wellbeing Lounge", and catch her practical masterclasses Psych Back to Basics on DisruptiveTV & Energy Top Up for resilience. For self development tools based within positive psychology: click Her YouTube Channel . Twitter/IG @draudreyt Order The Leader's Guide to Resilience or The Leader's Guide to Mindfulness or Be A Great Manager Now