Palliative care

[Meg888]

My 73yr old Mum has lung cancer and we've been told she is now going under palliative care. She's currently in hospital having broken her hip & having it replaced (her 3rd broken bone in about 6 months). She was diagnosed Dec 2010, and has been very positive throughout. They tried chemo, which ceased to work so they put her on radiotherapy, which was successful in shrinking the tumour. She has never appeared to be ill - a few months ago, she spent a lot of time sleeping and eating very little, but then she seemed to come back from that. She's very frail at mo, probably a stone underweight but is still very chipper. This is the first time MacMillan nurses have got involved, and I feel the way they are talking is like it is imminent, but my Mum seems to still have a lot left in her, she has always thought she would be cured of this illness, so we do treat her with kid gloves. Can anyone advise exactly what is involved with palliative care? Thanks in advance

[TheOtherHalf]

Sorry to hear your sad news. My mum has been in and out of hosp for the last few months and is losing weight fast. She 90 and weve been told that if her heart goes, she is too frail to resussitate. Its an awful feeling isnt it. The waiting. I really feel for you.
I think the Macm nurses just tender to their every need. They are marvalous so she is in good hands. Just find the strength the keep going yourself for when the inevitable happens. God bless x

[rowanwitch]

Difficult to say but she may drift along for a good few months just gradually getting worse but more likely she will deteriorate quite quicly, If she doesn't want to know the prognosis or wont accept it then I wouldn't push it until she is ready to come to terms with her end... kid gloves not especially just normal kindness and awareness that you will be dealing with your own sadness and sense of loss even before she dies and it will possibly colour your perceptions of what is happening. She may not be feeling your pain.. You may want to say things to her about what you are feeling or things that have happened and that should be ok although she may think its odd if she believes she will get better.. I think I'd say them regardless as you will regret it after if you don't.
you can always phrase things in less specific terms e.g eventually when you are gone ...

[LoftyLottie]

Personally, I understand palliative care to be designed for the need of each individual patient. I believe it means that although no further treatment can be given to possible cure, treatment is given to relieve pain and discomfort and also as much support as is necessary is given to give a patient as normal a life as is possible, although their condition is ultimately terminal.

You need to talk to the Macmillan nurses. Don't treat your mum with kid gloves, just continue as you always do.

[woofgang]

palliative care will involve whatever your Mum wants it to basically, although as LL has said, cure has usually been ruled out and the more heroic or uncomfortable treatments. Macmillan are there for you too remember. ((hugs))

[RATTER15]

Palliative care is all encompassing and MacMillan Nurses are the best at this. Palliative care is all about the family as a whole, not just the person that maybe dying, they tend to come on board fairly early so they can find out about any special needs that the patient or the family may have, they are fully trained to give excellent advice. They will look into specialist pain management (if required, it usually isnt) they talk to the family and will often help with financial, emotional problems and will be on call 24/7 to answer any concerns. They will also be totally honest whether you like it or not, people can cope better when they know what is coming and don't get unpleasant surprises.

Just trust them and talk to them about anything.

So sorry that you are having to go through this.

[RATTER15]

I have done a few courses in Palliative care, Woofgang and LoftyLottie has said it all really.

[beso]

Unfortunately our bodies rely on many systems to keep us alive. The failure of one of the critical systems can mean the end. Consequently the patient can be doing really well in many ways though still only have a short time to live.

Sometimes the failing system can stress another and take them unexpectedly.

Just treat her normally and talk about the joyous things you have shared in your lives. Happy memories of a life well lived and appreciated are often the most comforting thing for a person nearing their end.

[Meg888]

Thank you all for your most helpful replies. I spent best part of last year thinking and dwelling and expecting the end very soon, which (thankfully) did not happen. We thought Xmas 2010 would be our last with her, so to get the next one was an absolute bonus. My Mum is terrified of dying, she always has been even when she was fit. She will not watch anything where someone dies nor will she listen to a story/incident of the same. Her positive mental attitude toward her illness has been a big plus. My sister rang the nurse this morn, and the nurse told her she would rather talk to her face to face, so she is meeting with her this afternoon; are we going to find out something we didn't already know?

[woofgang]

doubtful, you sound well clued up and if your Mum doesn't want to talk about death and dying then the nurse won't.

[rowanwitch]

It may be they want to broach the subject of something extra in the care package like hospice day care.... don't worry it will be done in as sensitive a way as possible,

[boxtops]

Lottie's description of palliative care is excellent - people are referred when no further curative interventions are possible. However, people can be in palliative care for long periods, it's doesn't mean that time is extremely short.

Palliative care is wonderful - there is so much that can be done to ease pain and help people (in their own time) to come to terms with what's happening to them. I worked in a hospice for six years in the 1990s and it taught me so much... Best wishes to you and your mum, meg, you couldn't wish to have better care than you will have through the palliative care services.