Morphine and palliative care.

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Hi my mum is on palliative care. I am just getting my head around the prognosis as she was only diagnosed with cancer in October and then informed it's terminal in November 2024. She is slowly declining and can no longer eat. She hasn't eaten food for 4 weeks now but she does manage a daily milk shake. She is now bed ridden and has morphine tablets and can top up with oramorph every 2 hours. Her nurse is visiting fortnightly. She has been provided medical equipment to make sure she is comfortable. My question is rather taken the morphine tablets that is on 12 hour slow release, can this be taken another way. As she has difficulty swallowing tablets. She has gallbladder cancer that has spread to her stomach and breast . I know she has completed her hcp with her nurse but I would love to speak to some one and understand the process and next steps and what to look out for, her colour is changing and her skin is yellowish , she is skin and bone and I am guessing we haven't got much time left . 

  • Hi Fizz24.

    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 can see you’ve joined one of the forums, I do hope your finding it a supportive place.

    I’m sorry to learn about your mum’s diagnosis and that she’s now terminal. This understandably must be a very emotional time for you all, there are ways Macmillan can help with how you are feeling.

    I’m glad to hear that mum has access to the community nurses and they visit fortnightly, if you feel their visits need to be increased or another service is needed you can request this at any time. As cancer progresses the needs of the individual may change so more or different support may be needed.

    I understand you are concerned about mum’s morphine being in tablet form as she’s struggling to swallow tablets now. Morphine is available in other forms such as liquids, injections and suppositories that may be easier for mum as this stage. I’d encourage you to have a chat with her nurse or her GP about this as they can assess each form and decide what would be best to swap to.

    There are other pain medications that come as a skin patch that’s changed every 12 or 24 hours, this could also be looked into for your mum.

    It’s natural to want to know what to expect going forward when someone you love has advanced cancer. As we are not directly involved with mum’s care we’re unable to say how long she may have at this stage. The palliative care nurses are best placed to discuss this with as they know her best and also will be assessing this each visit. They look at the changes in symptoms mum is having, how her pain is and what she’s able to do.

    Mum being able to do less but experiencing more symptoms can be an indication there’s not much time. They tend to say if things change month to month, the time may be in months, if the changes are week to week, the time may be in weeks, and if things are changing from day to day if could then be days.

    Some things you can see at a time like this can be lack of energy but difficultly sleeping, weight loss and loss of appetite, feeling sick, and experiencing breathlessness. For most symptoms there is something the nurses can do to ease and support such as give medications. The yellow skin (jaundice) you mentioned is common when cancer is in the gallbladder as the bile duct can become blocked.

    It's important to report any new or worsening symptom to the nurses in between their visits.

    It’s never easy going through something like this if you feel a chat with one of the nurses on the Macmillan Support Line would be helpful please do call us, we are always happy to take your call.

    It may also be beneficial to ask mum’s nurses if there are Marie Curie nurses available in your area and to be referred as they can also visit and support you both at this time.

    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/Khe