Palliative care

We have received PET scan results today following radiotherapy and chemotherapy for a tumour on the base of the tongue for my dad earlier this year.  The news was devastating. The cancer had initially spread to the lymph nodes in his neck initially and there were no signs else where before treatment.   We have been told that the initial tumour has gone however there is signs of metastasis in his chest, spine, pelvis, liver, spleen and at various areas in his skeleton. 

We are waiting on a follow up appointment to discuss palliative care plan. My head is spinning, Dads Dr has said he has months as apposed to years left to live. Can anyone best advise me on how to cope with this news. I want to be able to prolong my Dads life for as long as possible and feel somewhat out of my depth not knowing how to react to this news. Through out his treatment there has been a heavy reliance on me to support my Dad on an emotional level.  He does not have much fight left in him and I want to be positive and help as much as I can, however, I am lost as I no longer know the difference between the right and wrong thing to say anymore. 

  • Hi there .. so so sorry your having this heartbrake time ...

    There is no right or wrong way to feel ... your probably having all the emotions under the sun right now .. a terminal diagnosis is the hardest to get our heads around ... all I can say is what I'd do .. as I lost my mum suddenly to a heart attack she was fine one Monday morning, and we list her at 5.20 that afternoon .. I'd give anything to have had just one more day with her , even an hour ..

    So if I were you, I'd just go with the day,  hold his hand and would say all that I wanted him to know .. I'd say how proud I was to have him for a dad ... I'd share tears... I'd admit I'm scared ... but there's no more he needs now, except a hand to hold ... l don't know how far down his journey he is ... but if mobile I'd ask if there was something he wants to do, or see... listen about his life... ask if there's anything he needs to say, even though it may be hard to hear .. 

    I'd take every day every hour as a bonus ... but most of all care for your heart too .. although you seem to be keeping everything together , but you need to feel all those feelings, scream, get angry, shout at this crule cancer .. you need to feel them... say to yourself it's O.K ... stop trying to be super woman .. your just human, it's just getting a balance of those emotions  and you need a hug and a hand to hold too .. so I'm sending you a vertual one to you right now ... youve got that time i never got ... you can do this .. your stronger then you realise ..,  Chrissie

  • Thanks for the reply Chrissie, I’m sorry to hear of your loss.  We are all so numb. Right now I dont want to be upset in front of my dad and he is trying not be be upset in front of us.  I’m sure that will change in time. I’m too used to being the one with answers and to this I have none and like you say will need to take each day as it comes. My dad is mobile at the moment however he doesn’t want to leave the house, maybe tomorrow things will change. Suppose we are all trying to digest the news in our own way x 

  • I just started working for a hospice in their office. They do offer help for relatives and it can help just to have someone to talk to who is not in the family (volunteers / trained councellours). Or you may want specific help or information. I’m not sure how it works if you don’t have a referral to a hospice, maybe your palliative care nurse can help. It sounds like you personally have a lot on your shoulders xx don’t worry that you don’t always know what to say xx

  • thanks. We have an appointment next week at the hospital to discuss care plan. Hopefully then we will know who to turn to for help

  • A difficult time and I have no words of wisdom to offer - none for myself either really. Just a question of doing what one can....hour to hour, day to day. 

    If you skim my "Hospital Discharge and Reality" thread you will see that (although I think support varies a lot by locality) you may find you very much have to drive the whole process of a "care plan" yourself. This of course gives one "something to do", not a bad thing. I completely understand your desire to prolong your dad's life as long as possible, but there can come a point where that is not a kindness.  

    I wish you well. Do not neglect your own needs and health. 

     

  • Hi LizannB,

    I think it would help both you and your dad if you could share the emotion of sadness. If you can bring yourself to cry and express you sadness at his diagnosis and prognosis, you may enable him to give vent to those feelings as well. It's cathartic and you'll have addressed the elephant, his impending death.

    It will give you further freedom to say anything and everything and acknowledge each others feelings as they occur. It'll also get you sooner to a state of acceptance - 'This is the way things are and we'll walk the journey together, hand in hand and moment to moment'

    And all both of you ever need to be, is 'sufficient to the moment'.

    Deal with what's happening now and move on to the next moment. This moment may be taking meds, the next may be laughing at something, the next crying, because one of you has had a sad thought. Don't think about the days or weeks ahead, other than in practical matters. If there are affairs to get in order, do it in 'this' moment, then forget about them and move on.

    I'd think not in terms of extending life by a week or a day or an hour but of living each moment along the way, no matter how long the way is. And living can be as simple as sitting quietly, sharing each other's company.

    Think palliative, so each moment is as free from pain and stress as possible. For both of you.

    Please remember, these are my thoughts on your situation and may have no relevance at all to you. I may be wrong. I probably am.

    In any case, I wish you and your dad the best

     

    Regards

    Taff

  • Thanks for your message. During my dads hospital appointment I was given a few minutes to speak with his consultant to ask difficult and frank questions regarding prognosis. My dad is not aware of this and the only thing that is keeping him semi content is not knowing this. We are looking for a miracle and are attempting to use herbal alternatives as a means of fostering some sort of hope for the future. I really don’t think there would be any good to come from my dad being aware of his life expectancy. He would shut down he is clearly very depressed and is refusing to eat without being being coaxed into doing so. It’s exhausting for all involved. For the next few weeks (hopefully longer) we are hoping to continue with this sharada only so my dad enjoy doing normal things while he is able to. I am no looking forward to his appointment this coming Friday. I fear there maybe more information given to him which will drop the veil and send him further into a depression which will only speed up his decline. 

    We we had a good day today. These last 4 days have been gruelling I can only hope that we have more days like this. 

  • Thanks for your advice it’s very much appreciated. We were advices 4/6 weeks ago that the dr could not see the initial tumour and to wait for pet scan and should take this as good news and that the pet scan would pick up any other activity which could not be seen by the naked eye. You can imagine our shock when the pet scan lit several other areas of cancer which were not know to the doctor or us. We are still dealing with the shock at this revelation and are somewhat miffed at how such a significant change was only picked up at this later stage.  As the weeks progress my dads dr has advised we will witness increased pain, frailty, weight loss and a general decline. We’re taking the good if and when we can as the inevitable will be here before we know it.