God, grant me the serenity
to accept the things I cannot change, the
courage to change the things I can, and the
wisdom to know the difference.
— St. Francis
of Assisi
When a patient and her healthcare
team decide that the cancer can no longer
be controlled or improved with treatment,
they may choose to end treatment. Palliative
care may begin, focusing on making the patient
comfortable. This often includes medications
and treatment, but these are used for controlling
pain and other symptoms.
Patients and their
family members often want to know how long
a person is expected to live. This can
be a difficult question to answer. Although
doctors may be able to make an estimate
based on what they know about the patient,
they might be hesitant to do so. Doctors
may be concerned about over- or under-estimating
the patient’s life
span. They might also be fearful of instilling
false hope or destroying a person’s
hope.
The time at the end of life
is different for each person. Each individual
has unique needs for information, care and
support. Some of the issues that may arise
include spiritual, psychological, legal,
medical and financial ones. If you and your
family are able to plan ahead, the situation
may be less stressful or traumatic, and more
peaceful, for everyone involved.
Services
are available to help patients and their
families with the medical, psychological,
and spiritual issues surrounding dying.
A hospice agency often provides such services
(more about hospice later in the section).
SOME
SUGGESTIONS FOR THE PERSON FACING THE END
OF LIFE
Talk about death and make your
wishes known. Rarely, if ever, do we have
conversations about how we want to live
in the final phase of our lives. It is
important to have thoughtful and serious
discussions with your loved ones about
what you want as the end of life draws
near. The time to discuss your views
about end-of-life care is before a crisis
hits.
Plan ahead. Let your loved
ones know what you want while you are able
to communicate your preferences for care.
Continue to have regular discussions
about your views, as they may change
over time. Plan ahead by drawing up
advance directives (legal papers which
allow people to state their decisions
about end-of-life care ahead of time).
Advance directives can usually be obtained
from your healthcare provider or hospital.
They can be changed at any time, even
after they are signed. You don’t
need a lawyer to complete an advance
directive, but each state has its own
laws for creating them. For more information
and assistance with advance directives,
see the Resources at the end of this
section. Advance directives include:
•
