My MIL had oral cancer 6 1/2 yrs ago, lost part of the roof of her mouth, all her teeth (has implants now), her sinus, and nearly lost her one good eye... surgerical treatment only (we were not living with her at the time and were not aware the docs didnt suggest she get radiation/chemo!)

3 yrs later, esophageal cancer, new primary, had radiation and chemo. 3 bouts with skin cancer on her face later, she had yet another primary oral cancer near the corner of her mouth last fall and went through radiation. Now it appears she has another oral cancer on the other side of her mouth, this time near her jaw where the implant is (might end up having to go without implants on the bottom as she refuses to go through the torture that getting them initially entailed). She is 85,and really really ready to say she is done. She was supposed to have knee replacement surgery next week, as her knees are shot and she nearly falls even with a walker and assistance whenever she walks anywhere.

My mom suggested talking to the doc about just doing some palliative surgery and then going on hospice, for the pain control and to help her (and us) through whatever is to come. She is tube fed and has been since the esophageal cancer. Just looking at her face yesterday when we were talking with her ENT, I could see what little spirit she has left withering away.

Any thoughts, suggestions, hope? I feel so badly for her...

Heidi

That is such a hard decision to have to make. I feel for you and your MIL. I don't have much experience with hospice and that situation - but I would imagine that your MIL will tell you when she is ready and that you'll just need to be supportive and understanding. She has already been through so much. Maybe you can get a pastor, priest or other religious person involved if she partakes in any religion. They have dealth extensively with it. You could make the call to the person she'd be comfortable with and explain the situation. Usually they can take it from there. I don't think they suggest hospice or anything but they help to counsel the patient and might help her to come to peace with herself on what she wants to do.

Heidi, After 3 months in hospital after hip surgery that did not heal well, my [84 yr old] Mom told me "enough was enough" one afternoon when I came to see her. She was gone the next morning. I knew she wanted to go- she had no fear of death and she hated the indigities of her life in the hospital. She was at last at peace-we were the wrecks. Tell her you love her and hold her hand and make sure she isn't in pain. Amy

Since my father and step mother were both in hospice (not at the same time) and I was the primary caregiver for my father I do have experience with this. Talk to her. My father and I carefully weighed out all of the options before we (mainly he) decided that enough was enough. He also had a broken femur, bad heart, lymphoma and required around the clock caregiving and we honored his wishes to be at home. The hospice people were wonderful and gave us great training and support. They did everything humanely possible to provide a painfree and dignified death, not to mention respite care, training and support for all of the caregivers. They even provided a chaplin and grief support afterwards.

Your Mother-in-law should be the one who decides 'enough is enough'. But before she does that she needs to discuss with the doctor what the treatment would be, what the side effects whould be, and what will happen and how quickly if she decides to forgo treatment. No one wants a lingering, painful death. Without those answers, I don't think she can make an informed decision. Hospice was wonderful for my father but not available until last 6 months.

Take care,
Eileen

Absolutely she needs to be the one to decide what happens and when. The problem is that she is at the point where she cant really make decisions... when we talk with her about even simple decisions she says I just dont know, and tells us to decide. We have told her that she has to make this kind of decision herself, that we can not make it for her. She DID decide a few months ago to place a DNR order so that if she has a heart attack or other serious illness they will not resuscitate her but will provide comfort care. We have it taped to her bed, with copies in other places as well (in case her caregiver is alone with her if I have to be out with my boys... one has his own serious chronic issues with 30+ surgeries in 9 yrs).

She does know she doesnt want chemo or radiation again, she really wishes she could just get pneumonia and be done with life. She feels that she really has no quality of life anymore... what with the drooling, suctioning, pain issues... Getting old is HARD WORK!

She has asked me to talk with the doctor to get all the pro's and cons and what if's, and then talk to her about it after we get the information. She gets too flustered and confused when talking with the docs herself, picking up on one thing that might be totally not related to what is going on but it makes sense to her somehow. I will try to get the best information I can, and present it to her in a way that she can understand without being to confusing... my husband is not in a place emotionally where he can deal with this right now, he wants her to keep on fighting no matter what it takes, and I get the feeling from her she really is done fighting.

Anyway... thank you all for your thoughts. I do appreciate it tremendously!

Heidi

Heidi, We went thru this with husband's sister. She was only 49 when she passed away after a two year battle with brain tumor. Dale was young and vibrant and had so much life to live. She and my husband were very close; no one wanted to see her go. I think she held on longer and endured more suffering than any one should ever have to because of the family. Even though she was tired of fighting, we encouraged her to be brave and fight to the end. Everyone had the best intentions. But in hind sight, by doing this we put a lot of added pressure on her. I think we imposed a sort of "guilt" on her, making her feel like she was letting us down if she gave up. She didn't want to disappoint us and couldn't find peace as long as she had that guilty feeling.

I know this is hard for your husband and he wants her to fight. But, if she is ready to go, help him realize she needs to be able to do so with a peaceful heart and without the worry of disapointing those that are left behind.

If she is done fighting, I second Amy's advise: Tell her you love her, hold her hand and make sure she isn't in pain.

Hugs, Vickie