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For all the world’s teachings on death and dying, the patient who doesn’t lament it for one reason or another is rare.
- Some people are unprepared to die.
- Others are worried about those left behind.
- Some are angry.
- Many are frightened.
- Not everyone is hungry for more life, but almost everyone at some point feels apprehensive about letting go.
If you or someone you love is struggling with these issues, here are some tips to navigate the future.
Talk to your oncologist
Studies show that, when it comes to prognosis, oncologists and patients often have different interpretations of the information shared.
One found that, while oncologists said they had discussed a poor prognosis, many patients felt that they’d not been made aware of it.
Your oncologist should be clear on your prognosis and what that means, but never be afraid to push for more information – it is both appropriate and valuable to ask your oncologist about what to expect.
A lack of awareness or understanding of your prognosis could have major implications for acceptance and planning for the end of life.
In terms of details, dividing life expectancy into broad groups of days, weeks, months or years seems helpful for many people.
Asking your doctor to describe what decline may look like can also be helpful, as can getting an understanding of how people die from cancer, medically speaking – a question I’ve tackled here.
If you are not sure how or what to ask, get help from your family doctor or palliative care nurse, who can help you write out some questions to take to your next appointment.
Talk to each other
While it can be heart-wrenchingly difficult to talk about the finality of dying, patients and relatives say that even one discussion around an incurable situation can be helpful.
Acknowledging mortality allows doctors and families to ask the patient, directly, what they want.
This kind of honesty can infuse purpose to a time of challenge by allowing the patient to openly express love, regret and desires, and the family to fulfil the patient’s wishes – whether it’s for their final days or after death.
Martin Ledwick, head information nurse at Cancer Research UK, adds that friends and relatives should leave space for their loved one to express what they need at this time:
“Take their lead about how they want you to support and care for them,” he says.
“Sometimes they may want the opportunity to talk about deeper feelings, but at other times they may want to feel ‘normal’ and do some of the things they would normally do in your company.
“It is good to have the opportunity to be able to tell each other how you are feeling and express love, but sometimes it’s useful to be distracted from this.”
Live well before you die well
Being adequately informed about prognosis allows you control over your life.
A patient who has had multiple lines of chemotherapy may be offered yet another treatment, but if they have a realistic understanding of its effectiveness, they may choose to stop treatment and focus on “quality of life” – enjoying cherished experiences: spending time with family, enjoying favourite foods or sitting in a favourite environment.
Patients who accept the inevitability of death can make every day count, ultimately improving their own experience and leaving their loved ones in a better place. Continue reading
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