End-of-Life Issues for Cancer PatientsBy Dennis Thompson Jr. | Medically reviewed by Lindsey Marcellin, MD, MPH
Planning ahead can ease a cancer patient's suffering and restore a sense of control to the person's life.
(DrEddyClinic News) Cancer patients facing death have many important choices to make. Decisions on such cancer http://www.dreddyclinic.com/integrated_med/cancer.php
end-of-life issues as pain relief, medical care, and finances can greatly affect patients’ quality of life during their final months, weeks, and days. Planning ahead also can help cancer patients regain a sense of control that may have been lost during diagnosis and cancer treatment.End-of-Life Issues: Care
Cancer patients do not have to spend their last days in a hospital ward. When doctors say further cancer treatment will be fruitless, efforts can switch to palliative care, which shifts the focus from curing the cancer to relieving pain http://www.dreddyclinic.com/forum/viewtopic.php?f=94&t=31007
and restoring quality of life for the patient. Hospice, a system of providing palliative care, is usually meant for people who are not expected to live longer than six months, although exceptions are often made depending on the circumstances.
Because the focus is no longer on a cure, patients can receive palliative care in any one of a number of different settings. An important choice in cancer end-of-life issues is where the patient wants to live out the rest of his life. Options include:
- Hospice centers.
These medical facilities only provide palliative care. The rooms are designed to help patients feel at home and comfortable, with doctors, nurses, therapists, and medical staff available around-the-clock to help treat pain, emotional distress, and other symptoms.
- Home care.
Hospice care also can be provided in your home, often at a lower cost than at a hospice center or hospital. Nurses make regular visits, but most care might be provided by friends and family.
Many hospitals now offer hospice services. As with hospice centers, a medical team is available around-the-clock to help cancer patients maintain their quality of life.
- Nursing home.
If the cancer patient has been living in a nursing home, he may decide to receive hospice care there.
Most insurance plans, including Medicare and Medicaid, cover hospice care. The cancer patient’s plan should be checked before making the decision about where to receive hospice care.End-of-Life Issues: Treatment Decisions
Cancer end-of-life issues also involve what medical intervention, if any, the patient wants. In particular, cancer patients need to weigh whether to receive certain life-sustaining efforts. These include:
- Cardiopulmonary resuscitation.
Doctors probably will perform CPR on a patient whose heart has stopped or who has stopped breathing, unless the patient has indicated beforehand that he doesn't want to receive such treatment. "Do Not Resuscitate" orders are commonplace in hospitals, especially for hospice patients, for whom resuscitation might only prolong suffering.
Doctors can use a ventilator attached to a breathing tube placed in the lungs to keep a person alive after he has lost proper lung function. A tube placed down a person's nose or throat delivers air to the lungs, essentially breathing for the person. Hospice patients have decided to forgo this extreme means of care.
People who can no longer eat can be kept alive using liquid nutrients delivered by IV or through a tube inserted into the stomach. Some patients nearing the end of life may choose to reject this approach and get fluids and foods by mouth only as their hunger and thirst dictate, even if this results in little intake.End-of-Life Issues: Important Documents
Decisions made by cancer patients regarding hospice care and medical treatments can and should be written down. There are two important documents a patient should fill out to make sure his wishes are followed:
- Advance directives.
Also known as a living will, these instructions specify exactly what the patient wants and does not want for his end-of-life care. The directives contained in this document can be as simple or as complex as the patient chooses.
- A durable power of attorney.
The patient selects a trusted family member or friend who knows his wishes and can make decisions for him if he becomes incapacitated. The patient can choose one person to make both health care and financial decisions, or one person to make medical decisions and another to take care of finances.
As difficult as it is, having these discussions beforehand, instead of under pressure at a stressful moment or in a time of crisis, will ease the patient’s last days when that time comes.