Addressing the Needs of a Person with Terminal Cancer
When a person is dying of cancer, the goal of care is providing as much comfort as possible. Often a change is made from a cure focus to a care focus. This means providing comfort with the least invasive procedures, while maintaining privacy and dignity. A person who is dying of cancer has many needs.
Routine for sleep and rest
Lack of sleep may be caused by a number of reasons, such as visitors, discomfort, fear of not waking up, restlessness, or day and night confusion. Keep a night light on, a bell or intercom in the person’s room, or both. This will help the person if he or she is awakened and confused. A clock is also helpful.
Nutritional issues may be difficult to address. Nausea, vomiting, diarrhea, constipation, and eating less often go along with the effects of treatment and the progression of the disease. High protein shakes may help if the person is only able to eat or drink small amounts. A nasogastric or gastric tube can help with supplemental nutrition. The healthcare provider puts a gastric tube through the skin into the stomach. A nasogastric tube is a tube placed in through the nose and into the stomach. The tube delivers medicines, nutrition, or both. Total parenteral nutrition is when nutrients, calories, protein, fat, and all caloric needs are given through a vein. This may be needed if the person has nausea, vomiting, diarrhea, or all three.
Changes in bowel or bladder control
A seriously ill or dying person may have diarrhea, constipation, or incontinence. Care should be given to provide the person with a clean environment. It is also important not to embarrass or humiliate a person that has recently lost bowel or bladder control.
Various things can cause skin breakdown, pain, or both. Infection may occur in this case. The healthcare provider may talk with you about giving the person antibiotics.
Respiratory changes may happen from pneumonia, the effects of opioid medicines, or the disease getting worse. Often people will feel they can't catch their breath. This is often called air hunger, and it can be scary. Less oxygen in the bloodstream may also cause a seizure. The person may need oxygen given through the nose or by a mask for comfort. A simple fan aimed at the person may help ease the feeling of breathlessness. Sometimes medicines can also ease anxiety related to breathing problems.
Discharge from the nose, mouth, and throat may be difficult to manage with a terminally ill person. Suction devices are available. It may also help to put the person in a different position to help drain the extra discharge. Medicines can also help lessen the amount of discharge.
Every step should be taken to eliminate pain from the dying process. Pain control and management plans should be discussed before the person has a lot of pain. It is important to understand that the ultimate goal is comfort. Pain management is an important topic to discuss with the healthcare provider.
June 25, 2017
Levin, Mark, MD,Ziegler, Olivia, MS, PA