Options for Palliative Care

My mum has had her chemo paused. She has been undergoing chemo for around 2 years now to manage the cancer but on the understanding that it will only go so far without sideeffects.

She is now having those side effects and has been admitted and her Doctor has said they will pause the chemo, scan her and discuss.

My concern is that she doesn't want to discuss what it looks like next for her care. I have flaged up to both my parents the need for at least speaking to the hospices as care at home from my dad and I will be very limited and may not be appropriate as time goes on.

My understanding is that you can be cared for at home, or ask about a hospice but there is no guarantee that they will have room - so I am trying to allow for this by trying to get a plan in place, so that when we are at that stage it doesnt't fall to me to manage all of this in very pressured and upsetting times.

My mum is in denial and feels very negative about any discussions around this, I have mentioned counselling but its a no-go.

I am getting therapy myself as a lot of underlying issues are at play here (the main one is being left to sort all of this whilst both my parents ignore the practicalities of organising anything without a professional sorting it for them), and I am worried about how I will cope without some pathway to sort of place my parents on so that her well being is managed well.

  • Hi Ashleigh22,

    A very warm welcome to our forum.

    It sounds as if you are in a very difficult, but not uncommon, situation. What many of us do at this stage is to set up a Lasting Power of Attorney (LPA) for our parents. This is a legal document which your parents each need to sign. This gives you the right to make decisions on their behalf, should they lose cognitive faculty, as often happens with cancer patients towards the end-of-life. There are 2 types of LPAs - one is for health and medical issues and the other is for property and finance - it sounds as if you may need both. You can down load these forms from the internet but they have to be paid for and registered before they become legal. The cost is £82.00 each for each form - ie £82.00 x 4 for all 4 forms. This is you're doing it online. You can do it through a solicitor, but this is likely to cost more.

    The options at this stage are for your mum to stay in her home with care provision, to go into a hospice or care home. There can be a waiting list in some areas for the last two. It sounds as if you might also benefit from the help of a social worker who can help you and your parents to make the right choices. S/he can arrange for any transfers to be made or any disability aids or equipment to be delivered. For instance, she can get a hospital bed delivered if your mum needs one. She might need to ask a few questions about your parent's finances before she can arranger for carers and nurses to come in, but it is a straight forward procedure. Your mum's care team in the hospital can arrange some of this too, but I personally found that the social worker was better for my in-laws, as she looked at everything that needed to be done and really did consider their well-being.

    Is your dad still at home and how is his health? I suspect that the hospice would only take your mum, so you might still have to consider what would be best for him. I am sorry to hear that you have been left to sort out their house. This is always a mammoth task - do you have any other family or friends who could help you out? There are firms who do house clearances, but they can be costly and even mementos that you may want to keep can disappear this way.

    I am sorry to hear of all that you are going through and I hope that you find some solutions soon. Don't delay in trying to action these changes, as you'll need something in place before your mum is discharged. You would also find it helpful to talk to her care team, tell them the position you're in and see what they advise. You may find it useful to draw up a list of questions before you speak to them.

    Hope this helps. Please let us know how you get on.

    Kind regards,

    Jolamine xx

  • Hi

    Yes i'm aware of LPA's, I could mention that as an option. But they may be more comfortable doing this themselves.  I wouldn't be happy with a social worker being involved as I am here, they just need to try managing decisions a lot better and at least take some steps towards this, I know it must be difficult.

    They haven't asked me to sort the house but it's not safe or appropriate at the minute for her to receive care in (in my opinion) but I will broach this. She isn't in hospital at the minute as she has been discharged, however there is a meeting at the end of the month to discuss the results of her scan and the decision re stopping/resuming chemo.

    Thank you for your response.

  • My dear Ashleugh22

    I know how difficult it can to do this all yourself the moderator has given some good pointers

    Re social worker they really are the key holders for care packages has your mum is in hospital ask to speak to the gospital social worker asap. They will assess Mums needs and can get things set up for her .

    We had an unfortunate exoerience with our hospital they didnt do the referal to SW and we ended up on a right mess

    The SW from local council picked us up and organised it but thst was over a week being home

    Take care 

    RB

  • Apologies I mis read the post and now see your Mum is home. Suggest you contact your local Adult services team asap ..things take time and also mums gp to say how concerned you are and beed some suppirt to keep your parents safe and comfy at home 

    Kind regards..RB

  • Hi Ashleigh,

    It would be easy enough for you to download the LPA forms for them and help them to fill them in. For once, they are not too onerous to fill in, but both of your parents would need to sign them and have their signature witnessed. It is a lot of additional work for you to have to sort the house out - and possibly more difficult to do now that your mum is home - as she won't want to get rid of things? - a common problem!

    I appreciate that you are on hand for your parents, but this is a lot to take on when you're on your own. I was in a similar position with my in-laws, who were both in their 90s. I was with them when they saw the social worker in their own home. We discussed the best options for them both and after she left us on the Friday afternoon, she had everything in place by the Monday - hospital bed, meals delivered, incontinence pads delivered, Build up drinks and puddings delivered, medication sorted and on a regular delivery schedule to be delivered to the house, carers coming in 4 times a day, visits from district and practice nurses and she even managed to get their GP (who had previously told them that he "didn't do home visits") to visit them on the Friday afternoon and then make subsequent visits. There is just no way that I could have done so much so quickly and that was at a weekend too!

    Just to clarify Rhubarbdragon's comments, I am not one of the moderators. I am just one of the many unfortunates who has experienced the hardships and challenges of cancer from many different angles.

    I hope that you manage to make some headway with this.

    Do please keep in touch.

    Kind regards,

    Jolamine xx

  • Hi

    Thank you both.

    I have spoken to friends today and I am going to speak to the Macmillan nurse and take it from there. I can consider the Adult Care aspect from there. I just want them to have some input rather than my mum potentially not receiving proper care (from my dad) whilst hes waiting for the grown ups to advise him or tell him what has to happen.

    I feel angry that they haven't asked or really done anything in this regard, just for their own information if nothing else. But this is pretty much par for the course with my parents unfortunately. Hence me coming on here for support/rant.

    I need to speak to my dad about the house and give him an option of some paid help to at least clean and sort all of the stuff that has accumulated stuff so that social workers or care staff can make headway in the house itself.

    It's a really difficult time for them but I know the pressure they put me under so I am trying to avoid that happening at a crucial time for me in terms of my own mental health.

    I don't even know what to do anout work as I have honestly wept for 6 weeks and I am worried about my resilience,

  • Hi Ashleigh 

    Im glad you are going to speak to Macmillian they are open 8-8 every day on their support line and chat line I found them very helpful 

    Sorted out financial situation 

    Which was a huge help filled all the forms in etc

    I personally wd consider that asap they can signpost you to other things They also offer emotional support too which may be what you need at the moment.

    You have to look after yourself Ashleigh it is a lot to cope with when both parents need support at ge same time.

    Perhaps have a chat to your gp and see what help support for you in your area?  Maybe a week off work then go from there ..

    I know thats a lot to think on  so take one at a time.

    Sending big hugs you are a good daughter

    RB

  • Thank you.

    My dad is just quite ignorant of things something and can be a bit selfish regarding my mums needs as he is very independant. So whilst he doesn't need care as such, I think I do need to raise the issue of an LPA with my mum at the very least to support my dad.

    As I said i've booked therapy, and I understand that it will be weekly I think and I feel like once that start it will hwlp.

    It's complicated with my mum. She has had her own trauma and addictions which in turn have massively impacted me and our relationship.

  • Hi Ashleigh 

    I am glad to hear you have got therapy organised for yourself.

    Cancer is a rollercoaster and can bring all sorts of stuff up. So you  are not alone in that

    Top tip make time to do something you find enjoyable non cancer related as often as you can.....a walk a cuppa whatever works for you ....and stick to it 

    Sending strength

    RB