It can be painful and frustrating to watch a family member or friend refuse treatment or avoid medical help. Although you can try to imagine what they are feeling, chances are their experience is going to be much different than yours. How can you help and support your loved one, and how do you adjust to certain decisions he or she makes that you may or may not agree with?

Get in touch with your own feelings first. It is often difficult to remain objective when a family member or friend suddenly stops his or her treatment. However, the decision whether to receive treatment or stop treatment belongs to them. It may be helpful to focus on their needs and not your own when you talk with them about their decision.

Identify the reasons they are resisting help. While certain decisions may not always seem like the right ones to you, in order to give advice or have an opinion about anything you have to know the facts first. Take the time to talk with them about what they are feeling and help them explore their own emotions, hopes, and fears. Identify the driving force behind their decision and if it sounds reasonable to you, then provide encouragement and support. If you think they are not making good sense or their thinking is different from what you recognize from the past, perhaps you need to discuss this with another family member or even a member of the medical team. On occasion, depression may interfere with a person's ability to make good treatment choices; this needs to be addressed and treated.

Get the facts. Talk with your family member or friend about what is happening in the present and what they imagine will happen in the future. Find out how they are feeling both physically and emotionally and how they feel about their treatment. Has the treatment stopped working, or have they decided to stop treatment because of physical or emotional side effects? Encourage them to talk with their doctor about things that can be done to make treatment easier to tolerate. If treatment is not working as well as they would have hoped and it's interfering with their quality of life, it may be a good idea to sit down and talk with them about their expectations for the future and ways in which you may be able to help. Find out why they may not want to seek medical help for a problem they may be having, and come up with a plan to address the situation.

Certain physical and emotional states can also influence a person's ability to make educated decisions.

Fear. This is an emotion that can be so overwhelming it can cause someone to lose focus and cloud judgment. Encourage your loved one to talk about why they may be fearful of treatment or why they are afraid to go to the doctor. Facing one's fears allows a person to move forward and gives back some sense of control to that person, allowing them to have a better perspective on certain situations.

Denial. Some people find that avoiding the reality of the situation is temporarily helpful. Denying the problem exists helps a person avoid feelings, such as despair and hopelessness. However, most patients who are seriously ill do find comfort in knowing enough medical facts to give them a voice in decision-making and control over their choices and their future. Provide your loved one with factual information in such a way that you help them understand the information without making it too frightening. Be persistent without being overbearing since this may cause more resistance.

Anger. A cancer diagnosis can be the most frightening experience in a person's life. There may be times, however, during treatment when things don't go as well as expected and a person may become angry and bitter that the whole experience is happening to them. It is important to give them the opportunity to work through this anger and, if at all possible, refocus their emotions.

Depression. A person with cancer can become depressed at any time during the course of his or her illness and this may impair his or her ability to make decisions. Encourage your loved one to verbalize his or her feelings, especially if present treatment is not working as well as expected. Often, once the underlying factor for the depression is identified, the best course of treatment can be determined. Seeking professional help may be an alternative, if it is affecting overall function.

Fatigue. When someone is tired all the time, it may be impossible for him or her to carry out activities of daily living. If severe fatigue occurs, it may be difficult for your friend or family member to function. This may also impact on his or her tolerance of treatment and the decision to continue or stop further treatment.

Uncontrolled pain. Pain can be debilitating and exhausting both emotionally and physically. Whether it is caused by treatment or the cancer itself, pain needs to be addressed and reevaluated often, so adequate pain management can be achieved. You may need to find out if the pain is so bad it is interfering with your loved one's ability to get back and forth from treatment. Offer ways to help. Encourage your loved one to review his or her present pain management strategies with the doctor.

Personal values. Quality-of-life issues, spiritual concerns and beliefs, and expectations of the future may cause your family member or friend to rethink the present situation. Provide an atmosphere where your loved one feels comfortable discussing these issues and see if any of them play a role in his or her decision making.

Respect the wishes of your loved one while still supporting them. Even though this may be difficult to do at times, you have to put the wants and needs of your loved one first. You cannot force someone to decide one way or another. Though you may not agree with their decision, it is important that they know that you are there for them and support them.

Talk with a professional. If you find it difficult to maintain a neutral attitude about their decision, it may be helpful to talk with someone who can be more objective. There are also many support groups available where caregivers can discuss how they are feeling and coping with others experiencing similar situations.

Know your limitations. Your loved one has the right to refuse treatment, even after all the facts have been presented to them to make an educated decision. In fact, stopping treatment may be the "right" decision and one you can fully support. What matters is that you have considered all options and decided on what feels best for you and your family and loved ones. If you feel, however, that there is an emergency situation that is being ignored, seek help from a professional or another family member.

Be straightforward. You can be honest about how you feel about their decision and talk to them about it. Do not overburden your loved one with the difficulty you are having about his or her decision. Be firm about your concerns while still coming across concerned and empathetic.

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