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My Fathers Bowel Cancer end of life care

Stepho
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Hello,

My father is coming to the end of his life having had terminal bowel cancer now for 4 years. He is in care home being looked after 24/7. He was placed on a syringe driver last night as his pain has been getting worse over the last few weeks and it was the last resort they had. He is on fentanyl and midazolam. I was told at the beginning he would be very sleepy and not awake at all. He is not drinking or eating anything, do you have any advice for me to keep him comfortable and is it normal to not be drinking anything at all? I know this is coming to the end with him but does it look like I still have time left? Or does it sound like his death is imminent? Any advice will be much appreciated and thank you.

  • Hi Stepho.

    Thanks for getting in touch and welcome to our online community. My name is Sherrye and I’m one of the Cancer Information Nurse Specialists on the Macmillan Support Line.

    I’m sorry to learn that your father is coming to the end of his life having had terminal bowel cancer for 4 years now.

    It sounds like the care home staff have been monitoring your fathers symptoms closely and felt his pain needed more control, if the current medication is not working or an individual is unable to take pain medication orally a syringe driver is used.

    It’s normal to find a person’s appetite reduces as they near the end of life, the body slows down and does not need as much food as it cannot digest it or absorb nutrients from it. If your father does have moments where he’s awake enough to eat, make sure he’s sat up and try foods that are easy to chew and digest such as soup, yogurts, and ice cream.

    If he’s not wanting to drink, that’s ok. A couple of things you can do to help with his comfort are:

    • Mouth care – small sponges soaked in water or mild mouthwash used to moisten the gums, teeth, and lips to avoid these areas drying out and becoming sore.
    • Apply lip balm – can also prevent the lips drying out.

     

    It’s impossible for us to say how much time dad has left as we’re not directly involved in his care. The best placed people to give judgment on this are those caring for him in the care home.

    There are a few changes that they will be looking for that can indicate that your father is nearing death, such as skin and sensation changes and breathing changes.

    The skin can become colder, may change colour, and become more sensitive to touch – adding a light and warm blanket can bring comfort at this stage.  

    Breathing changes can include longer gaps between breaths, a quicker rate and can become noisy. This is due to fluid build-up in the air passages and can be distressing to witness but is not usually distressing for the person who is dying - the care staff can give medications to reduce this build-up.

    In the final moments of life a persons breathing will slow down more with longer pauses between and their abdominal muscles may take over control from the chest muscles.

    The death of a loved one is one of the hardest things to witness, if you need to talk we are always happy to on the Macmillan Support Line.

    I hope this information helps. Please feel free to get back in touch if you want more information or support.

    Best wishes,

    Sherrye H,

    Cancer Information Nurse Specialist 

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm), send us an email or contact us through webchat.

    Ref SH/KM

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