Palliative care

Hello there ,

my dad is coming up for 95 and was diagnosed with esophageal cancer (adenocarcinoma ) in November , he had a stent fitted and is now back at home . He lives alone but can manage ok though he isn't eating all that well but he is only about half a stone different to when he went in hospital. They didn't recommend any treatment other than palliative care . The last couple of weeks he's been very down and says he's lost the will to live . But there are no real physical changes in him and he is about as active as he was before he went into hospital but the motivation isn't there to do things. We got in touch with his doctor who said there is no ongoing assessment plan for him and the hospital haven't been in touch to repeat his scans or anything . So my question is really , how do we know how fast it's growing or whether this is like the end of life stage or if he's getting depressed? So we don't know whether to drag him off to the garden centre or whethrr we should all be sat at his beside being glum . What do we do when we don't know anything ? 

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    Hello Billywhizzbang,

    Thanks for getting in touch and I can see that you’ve been getting some great advice from our wonderful Online Community members.

    It sounds as if you’ve all ben through such a lot recently as a family and it’s often difficult to know what to do for the best.

    It’s not uncommon for people affected by cancer to develop depression and one of the signs of this can be less motivation to do normal daily activities.

    The possibility of depression is something that should be assessed and we would suggest contacting your dad’s GP and if he has a community palliative care nurse then contact them too.

    If your dad doesn’t have a community palliative care nurse, then please consider asking your dad’s GP to make this referral as soon as possible.

    Not knowing exactly what’s happening with a loved one’s cancer can add to the sense of worry and from what you’ve written I’m guessing that’s how you feel right now.

    But sometimes, oncologists will decide that further scans are not the priority and that the focus should be managing any symptoms and maintaining someone’s quality of life for as long as possible.

    Sometimes, families need to try and switch their attention away from the disease itself and focus on how their loved one is and what changes are taking place.

    If your dad feels well enough to go out for a few hours with you then go ahead and do that, it’s not uncommon for people to need some encouragement to participate in family life but it’s worth persevering.

    When someone feels low it can be become a habit to isolate yourself and I’m sure you and your family are doing everything you can to support your dad at a really hard time.

    As I mentioned earlier, you dad’s low mood needs assessed alongside any other symptoms to decide whether he is depressed or that his cancer is advancing.
    Sometimes, it can be helpful for families to have some idea about what to look out for in the last few months, weeks and days of someone’s life.

    Please don’t click on the links until you feel ready to read the information. It can be upsetting but for many people the need to try and prepare yourself and feel better informed is important.

    What to look out for and what to expect is something that you can also discuss with your dad’s GP and palliative care nurse.

    I hope this information has been helpful but please don’t hesitate to get back in touch and of course you are welcome to call the information nurses on the support line to talk thing through in more detail.

    Best Wishes and take care,

    Elise

    Cancer Information Nurse Specialist

     

     

  • Thanks very much for your reply . It was really helpful. To be honest I'd forgotten about the palliative care people though it mentioned it in his hospital discharge notes , I got in touch with his go and we now have smashing nurse called Sarah who although dad isn't ready to see her yet, has gone through loads of stuff with me and a lot of my fears have been put to rest and its good to have someone at the end of the phone , dad still isn't eating too good but he is going for a blood sample so hopefully we will know more soon and this weekend he was much brighter and more cheerful , laughing and joking again, thank you again for your kind reply but for that we would still be blundering round in the dark wondering what to do !

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