What does end-of-life care mean for people who have cancer?
When a cancer patient’s health care team determines that the cancer can no longer be controlled, medical testing and cancer treatment often stop. But the person’s care continues, with an emphasis on improving their quality of life and that of their loved ones, and making them comfortable for the following weeks or months.
Medicines and treatments people receive at the end of life can control pain and other symptoms, such as constipation, nausea, and shortness of breath. Some people remain at home while receiving these treatments, whereas others enter a hospital or other facility. Either way, services are available to help patients and their families with the medical, psychological, social, andspiritual issues around dying. Hospice programs are the most comprehensive and coordinated providers of these services.
The period at the end of life is different for each person. The signs and symptoms people have vary as their illness continues, and each person has unique needs for information and support. Questions and concerns that family members have about the end of life should be discussed with each other, as well as with the health care team, as they arise.
Communication about end-of-life care and decision making during the final months of a person’s life are very important. Research has shown that if a person who has advanced cancer discusses his or her options for care with a doctor early on, that person’s level of stress decreases and their ability to cope with illness increases. Studies also show that patients prefer an open and honest conversation with their doctor about choices for end-of-life care early in the course of their disease, and are more satisfied when they have this talk.
Experts strongly encourage patients to complete advance directives, which are documents stating a person’s wishes for care.
How do doctors know how long a person will continue to live?
Patients and their family members often want to know how long a person who has cancer will continue to live. It’s normal to want to be prepared for the future. But predicting how long someone will continue to live is a hard question to answer. A number of factors, including the type of cancer, its location, and whether the patient has other illnesses, can affect what will happen.
Although doctors may be able to estimate the amount of time someone will continue to live based on what they know about that person, they might be hesitant to do so. They may be concerned about over- or under-estimating the person’s remaining life span. They also might be fearful of giving false hope or destroying a person’s will to live
here may be times when the caregiver needs assistance from the patient’s health care team. A caregiver can contact the patient’s doctor or nurse for help in any of the following situations:
- The patient is in pain that is not relieved by the prescribed dose of pain medication.
- The patient is experiencing onset of new symptoms, such as nausea, vomiting, increasing confusion, anxiety or restlessness.
- The patient is experiencing symptoms that were previously well controlled.
- The patient shows discomfort, such as by grimacing or moaning.
- The patient is having trouble breathing and seems upset.
- The patient is unable to urinate or empty the bowels.
- The patient has fallen.
- The patient is very depressed or talking about committing suicide.
- The caregiver has difficulty giving medicines to the patient.
- The caregiver is overwhelmed by caring for the patient, is too sad, or is afraid to be with the patient.
- The caregiver doesn’t know how to handle a certain situation.