Hi, I'm new here. Sorry this has turned out rather long. tl;dr: I'm caring for my 80 year old dad with terminal secondary liver cancer alongside my disabled mum who's waiting for a knee replacement.
My dad's secondary liver cancer came back a year ago after a year and a half of clear scans. He began with bowel cancer in 2016, was operated on within three weeks of his initial endoscopy, then recovered for a couple of months before having a liver section and finished his "just to make sure" chemotherapy in July 2017.
The past year has been difficult. He's been in and out of hospital an hour away from where he and my mum live with various temperatures, infections, jaundice etc. and most recently a fall. He was fitted with a picc line for chemo in February but jaundice stopped him having any treatment until May after he was fitted with stents to drain his blockages.
He had 3 cycles of chemo and then a scan, continued with the treatment and was told his blood tumour markers were rapidly decreasing and made us think positively. We had to wait a very long time for the scan results due to his specialist going on holiday. When the results finally arrived, it was bad news that the chemo had not worked. We were told he'd have a two week break and then a new treatment would begin. However, dad has been in and out of hospital and developed jaundice again.
The last time he was admitted to hospital he waited 14.5 hours on a trolley in A&E, stayed in for 10 days and was told that there was no point in having another stent fitted as it would do no good at all. The next day - Friday 13th - I brought him home with a just in case end of life drugs bag. I live over an hour away so have decided to move back in with my parents to help take care of my dad. I work from home, so I'm very lucky that I can do that. My mum has a broken back in two places, severe arthritis and is waiting for a knee replacement, so I'm currently running around after both her and my dad while working full time as well.
Neighbours and friends have done the "anything I can do to help" offers but I really do feel a little alone in all this. We had a wonderful MacMillan nurse visit on Tuesday for two hours and she's sorted out benefits for mum, dad's Respect form so he doesn't have to go back into hospital, social services and two carers visiting each morning between 9 and 9.30 to wash my dad. We had a zimmaframe delivered on Wednesday and now, Sunday, his legs are too weak to use it more than once a day. Yesterday a hospital bed and a commode were delivered and the men phoned just an hour before to say the room needed to be cleared and that they wouldn't help do it, queue me running around moving heavy furniture on my own and leaving me in agony today. How on earth mum would have coped without me I do not know.
On Tuesday night mum - who is sleeping in a chair downstairs to be with dad overnight - woke me to say dad was unsettled, so we got the district nurses out of hours team to visit to give dad a calming drug from his just in case bag. On Thursday dad had his first dose of oramorph and then fell at 3am, leading us to get the paramedics out as I couldn't lift him on my own. On Friday (mad Friday - the last before Christmas) he fell again at 1am, mum again woke me and I couldn't lift him again, so we waited until 2.30am for the paramedics. On Saturday morning he fell again, but it was at a decent time so I got one of my parents' neighbours to help me lift him up. Today dad can't walk to the downstairs bathroom at all and is using the commode after vehemently refusing to have one.
The rapid deterioration is the scariest thing. We can literally see him fading a little more each day. The steroids he's on are giving him terrible mood swings (today he yelled and swore when the Morrison's delivery lady knocked at the door) and he's getting frustrated when we can't understand what he's saying. He's seeing a woman doctor in the room among other people who aren't there and regularly talks in his sleep. He has moments of lucidity, but not many - less each day.
Seeing my dad who has always been active - we both walked Hadrian's Wall just 6 years ago - become a sick man, wearing disposable pants, having liquid Complan meals from beakers, needing to be cleaned up after each frequent toilet and trying to drink from the tv remote is truly heartbreaking. He needs everything doing for him and his tastes - fancying this and then that to eat - have me run ragged. One moment he wants trifle, the next bacon, the next egg custards so I have to leap up whether I'm working or not and get him whatever he wants just to try and get something, anything down him.
I'm 30 and luckily don't have any children yet, my husband and I have put it off so that I can look after my dad. My husband works away, so can only help on his days off, of which there are very few in the run up to Christmas. Dad's mum died on Christmas day nearly 40 years ago and it's his fear now that he won't make Christmas. Currently, my only respite is the 30 minutes before I sleep at night and the 30 minutes after my morning work when I walk my dog who's staying with me. For the past two mornings I've been unable to even do that, just taking her out for 5 minutes to do her business before going back to help my mum again.
It seems each time I prepare my mum's and my lunch, dad does a poo, so needs cleaning up and then we have to eat in the smell of poo. Mum is barely sleeping with dad walking at all hours and I'm really not sure how long she can go on without snapping. I feel I've aged about ten years in the past three and another year in the past week. In the time I've been writing this post I've made two trips to the kitchen for milk and sweets and helped my dad to the bathroom twice.
I'm not really looking for advice, I just need to get this all off my chest. Thank you for reading
TweedyAmy
Im tearing up reading your messages as I am in the exact same position with my dad. I can really hear a lot of the same frustrations and fears as I am facing, which is comforting in a way- but pretty awful for us both!
I usually live and work abroad but have been back and forth, and am now home for a while supporting mum and caring for dad.
For us everything came to a head last week, and we ended up asking for a lot more help (McMillan nurse at night, daily carers, and the district nurse comes twice daily now) This was not necessarily in line with my dads wishes, but we were at a loss trying to keep on top of his pain and agitation. I wish we had done so sooner as it’s taking a while to get all his care into place. I feel like we’ve always been a step behind in fulfilling his care needs (and looking after ourselves!)
I can relate to the perfectly cut sandwiches, as I feel like we can’t do anything right by my dad. Yesterday we put on a whole big show of trying to have a little Christmas Day celebration, with lots of little things just as he likes them, but it was so draining, and if anything just made him more agitated that usuall. It’s crazy as before he was ill he was the most laid back /easily pleased guy. The bed was also up and down more times than I could count.
I too have been so shocked at the realities of someone dying. The bbc should produce a show called “one gone every minute” One source I have found with a realistic portrayal of death was in a book called “with the end in mind” by Dr Katheryn Mannix. I found it very helpful in understanding the dying process, especially some of the unexpected happenings (restlesness, agitation, denial, lashing out, personality changes)
The biggest shock for me has been the timescale. I cant believe how long my dad has managed to go on in the state he is in. He has oesophageal cancer and is completely emaciated. I have been googling “signs of death” and “signs of last days” for weeks and he has all of the signs that he doesn’t have long left but is hanging on. I don’t want to wish him away but am just so shocked at how long he has held on and how difficult it’s been to care for him 24/7
Did you decide about hospice vs home? Or ask for any further help? How was Christmas for you? Hope you managed to have some nice moments and relaxation (or that it was at least bearable!)
TweedyAmy
Im tearing up reading your messages as I am in the exact same position with my dad. I can really hear a lot of the same frustrations and fears as I am facing, which is comforting in a way- but pretty awful for us both!
I usually live and work abroad but have been back and forth, and am now home for a while supporting mum and caring for dad.
For us everything came to a head last week, and we ended up asking for a lot more help (McMillan nurse at night, daily carers, and the district nurse comes twice daily now) This was not necessarily in line with my dads wishes, but we were at a loss trying to keep on top of his pain and agitation. I wish we had done so sooner as it’s taking a while to get all his care into place. I feel like we’ve always been a step behind in fulfilling his care needs (and looking after ourselves!)
I can relate to the perfectly cut sandwiches, as I feel like we can’t do anything right by my dad. Yesterday we put on a whole big show of trying to have a little Christmas Day celebration, with lots of little things just as he likes them, but it was so draining, and if anything just made him more agitated that usuall. It’s crazy as before he was ill he was the most laid back /easily pleased guy. The bed was also up and down more times than I could count.
I too have been so shocked at the realities of someone dying. The bbc should produce a show called “one gone every minute” One source I have found with a realistic portrayal of death was in a book called “with the end in mind” by Dr Katheryn Mannix. I found it very helpful in understanding the dying process, especially some of the unexpected happenings (restlesness, agitation, denial, lashing out, personality changes)
The biggest shock for me has been the timescale. I cant believe how long my dad has managed to go on in the state he is in. He has oesophageal cancer and is completely emaciated. I have been googling “signs of death” and “signs of last days” for weeks and he has all of the signs that he doesn’t have long left but is hanging on. I don’t want to wish him away but am just so shocked at how long he has held on and how difficult it’s been to care for him 24/7
Did you decide about hospice vs home? Or ask for any further help? How was Christmas for you? Hope you managed to have some nice moments and relaxation (or that it was at least bearable!)
Hi Pot_noodle
I don’t want to wish him away but am just so shocked at how long he has held on and how difficult it’s been to care for him 24/7
I have read your post and that statement sums up exactly how I feel and yes it is the timescale that is the most difficult thing to deal with. My nearly 90 year old dad was diagnosed with dementia over 2 years ago but it wasn't too bad, he could get by on his own with help. Then he stopped eating over Christmas 2017 and lost 4 stone in 4 months because he wasn't hungry.
The dementia made diagnosis difficult as they suspected anorexia caused by his new drug and it was only when he started to throw up every little thing that he had eaten that an endoscopy was ordered and he was finally diagnosed in April 2018 with advanced oesophageal cancer.
We were told that no treatment would be offered because chemo and dementia don't mix well and we all agreed but they would give him a stent and continue to monitor him. They referred us to the hospice and explained that dad would have everything needed to keep him comfortable This scared the hell out of me and I decided that I would keep dad at home and make everything as nice as possible for him because he was dying.
That was 20 months ago and since then he has had 2 more stents, put on 3 stone, lost another 2 and then regained one. Since March this year he has had pneumonia, 3 falls, a heart attack and a stroke but he is still here and just about mobile with a frame. He is very weak and sleeps 20 hours a day but he has been like that since the pneumonia in March which was when I had to start caring 24/7. I just feel blessed that he can still get take himself to the toilet.
Like you I have googled everything and dad should not be here but he is and I can see it just going on and on and why is it that the days drag by so slowly yet the years just disappear in the blink of an eye. It's 2020 next week and where the hell did the last 2 years go.
It feels like I was given a light at the end of the tunnel but the tunnel just keeps growing longer.
Dad is a lovely man and still very sweet and kind but it is so hard watching him declining like this and it doesn't help that his memory is shot and he actually has no idea that he is ill. He doesn't even realise that I am living with him. He has no symptoms other than can only manage small meals and he is very happy.
I am glad that you have managed to get some extra help and I think that I will have to look at that in the new year because this is getting to be more than I can cope with.
Wishing you and your family well.
Hi Pot_noodle, thanks for taking the time to read and to reply. So sorry to hear you're going through similar, huge hugs x
Like you, I've been googling like my own little search engine. Dad has every symptom that his days are numbered, not his weeks. He's been home now 13 days and his decline leads me to believe that we are on borrowed time.
My husband had his first Christmas off in 5 years yesterday and arrived in the morning. Dad was pleased to see him and for a few hours after lunch his delirium subsided slightly and he was able to sit up in bed while I opened his presents with (for) him. He got lots of sweets etc that were bought before the end of life care was decided on and he kept having a little nibble of everything. It was wonderful to see his eyes light up as the Christmas staples of Tobelerone, choc brazils and nougat were unwrapped for him.
We had dad asking for Christmas pudding 8 times yesterday before and while we were eating our lunch and I had to tell him not until we had finished eating. I felt cruel, but it was 11am and the pudding was still in its wrapper. He'd had turkey and pigs in blankets earlier because he was hungry. He ended the day being sick and two district nurses coming out to administer agitation and pain medicines.
Mum was up every hour last night and shouted me for help at 2am after poo-mageddon. No more chocolate now unfortunately.
Today has been a totally different ball game. carers came about 9.15- 9.45 and then mum went up for a wash - she's not managed a shower in about 5 days now. At 10.30 ish, dad started shaking all over and crying out that he was freezing. We piled bedding and blankets on him, heated up a wheat pack and put the electric blanket on, but still his teeth were chattering. I took his temperature - normal, so we called the district nurse line - no help, called the GP - no help, called 999 and two wonderful paramedics arrived. Took his temperature again and it was way up - our thermometer hadn't worked. Queue us stripping all the bedding off and trying to give dad paracetamol and water. So there's an infection somewhere, but it won't be treated.
The paramedics also told us they can administer just in case drugs - didn't know that and the night shift district nurses told us about sheath catheters, wendy sheets and all sorts that we didn't know about that would make life so much easier. Why is there no information pack?!!
Still waiting on a call about marie curie help.
I'm just so pleased that we had dad here mentally for those precious few hours yesterday afternoon. After the 999 drama this morning he's slept since noon until now (5.15pm) which has let me get on with work which I'm sorely behind on.
TweedyAmy,
That’s lovely you managed to have a few nice moments yesterday. It’s a shame your dad overdid the munching, but I guess that’s what Christmas is for! Good that he still has an appetite!
Sounds like you have had a hellish day today. We had a similar experience last weekend where we couldn’t control dads breathlessness. Distruct nurses wouldn’t come out and advised us to call 999, paramedic wouldn’t administer from just in case box (what exactly is it “just in case” of!?), This resulted in a three day stay in hospital where dad was so angry at us for calling 999 that he was verbally abusive any time there wasn’t a nurse or doctor in the room. It was like something out of a dark comedy sketch as he was nice as pie whenever anyone else was there!
From my extensive google research I also believe my dad to be in his last days, but i also thought that a few weeks ago! He is still really up and down. Sometimes he has been so completely out of it that I’ve said good night to him 100% convinced that he wouldn’t survive the night, only to be surprised that he is a bit brighter the next day.
Today my dad has slept all day today which has been such a blessing. Me and mum had a duvet day with movies and have just woken up from a 3 hour nap!
Hope you get the Marie Curie help in place soon to allow you and your mum to look after yourselves too!
Tomorrow I have a crimbo-limbo spa day tradition with my 2 best friends, so am praying that dad is having a good day and is stable enough for me to go.
Keep in touch! It’s a real comfort to know that I’m not alone in this (hope it is to you also)
It really is a comfort x
I so hope you get to enjoy your spa day.
I know exactly what you mean saying goodnight and being convinced that he won't survive. I've had a couple of nights like that and one day this week I came downstairs fully expecting my mum to be waiting to tell me bad news.
A 3 hour nap sounds absolute bliss! Savour it for me and my mum too. This morning me and my husband came downstairs around 7.30, made breakfast and then crept back upstairs to eat it as both my parents were fast asleep. We ate breakfast and decided to have a little half hour's extra sleep before the carers arrived, so I set an alarm for 8,50, put my head to the pillow and what did I hear except mum wheeling the commode into the lounge. So I headed back down and left hubs to get some shut eye.
The hospital situation sounds so similar to my dad. He was telling us things away from docs and nurses, so mum would relay that to them due to dad not telling them the truth. Then he'd get angry and pretend she was making it up just to not cause a fuss. Such a balancing act trying to do what's best and keep him happy.
Duggies-girl
I think we are living in different time scale than the rest of the world when dealing with cancer. Time is flying by and I feel like life is passing me by, but then some days the minutes feel like hours!
Compared to your dads journey mine has been relatively short. He was diagnosed as stage 3 in October last year and had 3 short rounds of chemo, which the tumor didn’t really respond to at all, so he was switched to palliative care. We almost lost him to a lung infection in May and he has never really recovered from that. He stoped eating then, and only has ensure drinks and nibbles of dinner here and there. Just 18 months ago he was a big strong guy, but was 7 stone when he was weighed last week, and my brother can lift him like he is a bag of shopping. That has been really shocking to see the physical transformation. We used to drive ourselves crazy trying to force feed him, but have gotten over that. I didn’t realise how little food the body actually needs to keep going.
Since May he was sleeping like crazy -like 20 hours of the day. From November this year his deterioration has accelerated from week to week and now from day to day. He is now suffering from pain and terminal agitation where he fights sleep and is restless all the time.
I cant even imagine how hard it’s been to have your dad have advanced cancer on top of the dementia, and to go through that (and so much else!) over such a long time. It sounds like things are stable for now, and it is great that your dad is happy day to day and can still manage the toilet. I’d definetly say to over-ask for help, as then at least you know what support and aids are and will be available.
Thinking of you and your family. Please remember to look after yourselfs too x
Just a little update while I have a couple of minutes.
Most amazingly: On Friday night a Marie Curie nurse came overnight between 10pm and 7am. We only found out around 7pm and then she called at 9pm to introduce herself. So mum got to sleep in her own bed.
We also have another night sitter arranged to come on the 31st Dec and 1st Jan, so mum can sleep then as well.
Dad is now completely bed bound and relying on his disposable pants for everything. Mum called Macmillan and District Nurses (DNs) on Friday to arrange more help. About two hours later we heard from Care Mark (who are giving dad his morning half hour wash currently) to say that on Monday there will be three visits and going forward from Tuesday, four daily visits.
For the first time in a while, we didn't have a DN out to administer anything from the just in case bag yesterday, dad said he had no pain after I gave him two paracetamols in the morning.
Most importantly, we've figured out that the violent outbursts were after dad taking Oromorph. Since his discomfort has been managed with paracetamol and painkillers in his just in case bag, there's been nothing like that at all.
He is still seeing things and kept staring over at the gap in the middle of the sofa yesterday between me and mum and asking if anyone was there. I kept shuffling cushions around so he could see that there wasn't. He also keeps asking about when my husband is coming back, so hopefully his visit today will brighten him up.
Thinking of you all x
TeeedyAmy,
So good to hear you have more support in place, and that your dad has settled down with the change in medication.
That was how our first Marie Curie night nurse arrived- we only got a phone call about 10 minutes before! She was like and angel sent from heaven though, and everything feels much easier on a decent nights sleep!
My dad has been restless and fighting sleep and is still up and down. He managed to watch his football team play their rivals today (on tv) I was devastated for him that his team lost!
My flight to go back was booked for today, and I was supposed to be back at work tomorrow, but have stayed at home. Don’t think my work are going to be too understanding, but I can’t really leave right now.
Hopefully things are stable over the new year for you x
Hi Pot-noodle, I hope work were understanding towards you. I can't imagine trying to juggle a "normal" job at this time. Thankfully, all I need is my laptop and I can work.
More of an update:
Dad hasn't been able to speak for about 3 days now, he had a syringe driver fitted with madazalam and morphine and the dose was doubled yesterday after it was clear the minimum amount wasn't cutting it.
I took my dog for a short walk and while out my mum called to tell me to hurry back, she thought it might be time as dad's breathing was getting very shallow and the gaps in between were increasing.
When we tell him we love him he sort of focuses on us and either nods or makes a little moaning sound, so we know he can still understand us. He hasn't had any food for four days and only a couple of tiny sips of water.
The carers coming four times a day is such a help now and mum was able to sleep in her bed two nights in a row on the 31st and the 1st.
Our Macmillan nurse came by yesterday to sign off on the driver drug increases and to prescribe more doses for over the weekend. It was nice to see her and me and mum were able to voice concerns and just chat to someone who understands. She could notice just how much weight he's lost since the last time she saw him. His hands are now cold all the time and sadly he has the start of a pressure sore just above his bottom, so the district nurse has given us some barrier spray.
I honestly now just hope that he can stay asleep until the end so he doesn't know what's going on. When he wakes at first, his eyes are so wide as though he's panicking, but he calms slightly as we hold his hands.
I think both me and mum are doing a bit of escapism/ denial. I keep looking at little holidays to take mum on in a few month's time and she keeps talking about how she's going to decorate the house. The brain is such a strange thing with how it tries to cope.
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