Cancer: End-of-Life Issues for the Caregiver

Dealing with the last stages of a loved one’s cancer is hard. It can be physically, emotionally, and mentally painful for everyone involved. Planning for certain issues in advance can help ease the burden. Ideally, you should make these decisions with your loved one if they are able to participate. It helps you know their wishes and gives them a sense of control. It relieves you from making all the decisions. Preparing allows you to be more present with your loved one in the final days.

The American Academy of Family Physicians (AAFP) recognizes that patients should have access to palliative care before the last 6 months of their life and/or hospice care in the last 6 months of their life.

Path to improved well being

There are many things to consider as a caregiver. Below are some end-of-life issues to discuss and plan with your loved one.

Palliative care

Palliative care is a service you can choose for your loved one. It’s not focused on treatment. It’s focused on relieving pain and symptoms. It also provides emotional, mental, and spiritual support. Palliative care focuses on living each day as fully as possible. Many people can be involved in this care. These can include members of the health care team, family, friends, and a counselor or spiritual advisor. Palliative care can take place in a home, hospital, or hospice setting.

Hospice care

Hospice care is another service for people who have cancer. It focuses on a holistic approach. This means treating the physical and mental effects of late-stage illness. Care members from different areas provide relief, comfort, support, and instruction. Hospice care often includes around-the-clock medical staff. Hospice care can take place at home or in a nursing home.

Medical decisions

Advance directives are instructions on what kind of care your loved one wishes to receive. Talk to your loved one about their requests. Then, work with a lawyer to create the documents. Follow the directives once your loved one is no longer able to make medical decisions. Types of directives include:

• Medical power of attorney
• Legal power of attorney
• Living will
• Do-not-resuscitate (DNR)
• Organ donation

Financial and legal issues

An accountant or lawyer can help sort through financial and legal issues. These may include your loved one’s insurance policies, bank accounts, or will. Ask your loved one where to find important documents and items. Examples are credit cards, bank accounts, retirement accounts, car titles, insurance policies, and mortgages.

Funeral arrangements

Perhaps the hardest part of this process is planning your loved one’s funeral. Talk with your loved one about their preferences. They may want a cremation or burial. They may want a public memorial or a private one. You can discuss budget depending on who is covering the costs. If your loved one wants a memorial service, you can talk about the arrangements. For example, they may want certain readings, prayers, or songs. They may want certain people to talk, preach, or carry the casket. Don’t feel that any detail is too small to discuss. You also can talk about what to include in their obituary or if they want donations.

When selecting a funeral provider, be sure to compare prices, services, and payment options. It will be easier to do this sooner rather than later. There will be less pressure and fewer distractions. Funeral laws vary by state. Research what is required and what is optional.

Things to consider

Being a caregiver may require you to miss some work. You may need time off before and/or after your loved one passes. Learn what your employer’s policies are for bereavement and family medical leave (FMLA).

Talk to your loved one about any other dying wishes or requests. They may want a final visit from family or friends. If they are spiritual or religious, they may want a leader to say prayers or have a service. Make a list of people to contact upon the death of your loved one. Often, this includes family, friends, employer, and community groups.

Questions to ask your doctor

• How do I know if my loved one is in the final stages of their life?
• How long does my loved one have to live after receiving a terminal cancer diagnosis?
• What type of care does my loved one need?
• How can I provide comfort and relief to my loved one?
• What kind of advance directives does my loved one need and what are their options?
• Can you recommend a support group for my loved one, my family, and me?
• What costs are associated with palliative and hospice care? Does insurance cover it?

Resources

Caregiver Action Network: Family Caregiver Toolbox

U.S. Department of Labor: Family and Medical Leave (FMLA)