End of Life Care for Seniors with Cancer
It can be challenging for even medical professionals to determine exactly how long a terminal cancer patient will survive. However, once it has been decided that the cancer can no longer be controlled and/or treatments are no longer in the patient’s best interest, it’s often advised that families begin considering end of life care options for their loved one. End of life care places an emphasis on helping terminal patients live as comfortably as possible in their final months, weeks and days of life.
This type of care is often administered at home through a hospice or palliative service that provides medications as directed by doctors, medical oversight and even respite care to give family members a break when necessary. However, end of life care for cancer patients can also take place in facilities such as nursing homes or hospitals. Wherever the care takes place, there needs to be an adequate support systems that helps patients and their families with medical, social, psychological and spiritual issues throughout the dying process and even afterwards.
The Role of End of Life Caregivers for Cancer Patients
The role of end of life caregivers might depend on how the patient has laid out their final wishes concerning how they prefer family members and care providers to handle medical and financial issues. These desires are usually contained within a set of legal documents and advanced directives that are created before the illness progresses too far. However, caregivers — whether they are relatives, friends, professionals or a combination of both—typically provide quite a bit of assistance to keep charges comfortable and pain-free.
Caregivers typically need to help patients in the latter stages with daily activities such as bathing, grooming, dressing, getting to the bathroom and eating. They are responsible for helping with medication administration and providing documentation for medical providers. End of life caregivers often assist with cooking, housekeeping and other light errands to support the family. These individuals often can provide emotional and spiritual support to families and patients as well. With so much to deal with, family members trying to manage it all can experience caregiver burnout, which may indicate that outside assistance is necessary.
When to Seek Outside End of Life Care from Professionals
End of life care that is handled at home can be intensive or minimal depending on the individual patient’s needs and current physical and emotional condition. While it’s increasingly common for family members to play a large role in home care settings in the early stages, once the final weeks and days arrive it’s often best to take advantage of any outside or temporary respite assistance that you can receive.
Hospice is the most comprehensive care option, and Medicare offers to assist financially once a doctor determines less than six months of life likely remain. In fact, most families actually express that they wished they’d sought out services earlier in the process, as hospice care seemed to improve their loved ones quality of life in the final days. So, knowing when to make the call to doctors or nurses on your care team can be tricky. However, here are some indicators that this time has arrived.
- When patients are in obvious pain and medications seem inadequate for their comfort.
- Any time patients experience new or worsening symptoms that were once under control.
- If patients are unable to empty their bladder or bowels for extended periods.
- When patients become uncooperative or seem excessively agitated more frequently.
- When patients show indications of serious breathing complications.
- If a patient falls, which can complicate matters.
Palliative and hospice care workers can be utilized in times of emergencies, part time, and can provide full-time care in certain situations even in home settings. Besides keeping loved ones comfortable, they can help families recognize the various signs of approaching death.
Signs and Symptoms During the Final Weeks and Days of Life
Death from cancer typically occurs after an individual has grown increasingly weak over several months, but this can depend on their particular diagnosis and whether other conditions are present concurrently. Patients and families who understand what to expect tend to experience less anxiety and can plan better for what lies ahead.
Those entering the final weeks of life may experience signs and symptoms including:
- Increasing weakness and longer periods of sleeping and/or staying in bed.
- Decreases in appetite or interest in foods and drinks.
- Weigh loss and thinning muscles.
- Less interest in hobbies or things in the outside world.
- Limiting visitors and only wanting a few people nearby.
- Decreased ability to speak clearly and concentrate for long periods.
During the final days of life, cancer patients may exhibit signs such as:
- Slow breaths with long pauses or noisy breathing that sounds rattled and gurgled as the individual is unable to clear their throat.
- Dry lips, mouth and overall skin dryness.
- Bluish or dusky colored skin, particularly in the hands and feet that may be cool to the touch.
- Drifting in and out of consciousness and becoming less responsive to sound or touch.
- Refusing most or all food or liquid, which can result in decreased urine and feces.
- Loss of bladder and bowel control.
- Repetitive, involuntary movements and reflex responses.
- Confusion about whom people are, the time and even where they are.
- Sudden surges of clarity or energy that quickly pass.
- Hallucinations are common, and patients often have dream-like experiences and may see loved ones who’ve previously passed on welcoming them cross over.
Every patient has a different experience in the final months and weeks of life, which is just one more reason to take advantage of end of life care options if a loved one is facing terminal cancer.