End-of-Life Care for Loved Ones with Cancer

When your loved one has cancer, a time might come when it can no longer be controlled. In that case, your loved one will stop testing and treatment. The focus will turn to giving your loved one comfort and emotional support, and planning what comes next.

When someone with cancer is getting close to the end of their life, you may see some fast changes. Or it can be a slow process. Preparing for these changes will help you ensure your loved one is as comfortable as they can be during their final days.

What are things to watch for?

Everyone is different. So it can be hard to predict how long someone will live with cancer. Some factors involved are the type of cancer, where it’s located, and if there are other health problems.

Some common signs that someone is approaching the end of their life are:

• Fatigue. Feelings of weakness and tiredness are getting worse.

• Sleeping more. They spend most of the day in bed.

• Losing weight. They lose muscle mass and burn through food faster.

• Decreased appetite. As the body stops being able to use food properly, the person will need and want less food. It may also be hard for them to eat or swallow liquids.

• Being less able to talk or focus. They may have a shorter attention span.

• Loss of interest. They may not feel interested in the same things as before.

What decisions can you help with?

You can help make some important decisions with your loved one. These include:

• Living arrangements. You may find an inpatient hospice center or a facility with assisted living. If your loved one chooses to live at home, you’ll decide if you’ll be the primary caregiver. You may also want to hire a hospice care team that can visit your loved one, teach you how to care for them, and also be available by phone. Respite care services are also available to give you a break from caregiving, even for a few hours.

• Advance directives. These are legal documents that say what your loved one wants to happen in the future.

• Living will. Your loved one can say how they’d like to be medically treated if they’re unable to make their own healthcare decisions.

• Durable power of attorney for healthcare. This is also called a healthcare agent. Your loved one chooses someone they trust to carry out their wishes if they are unable to make decisions.

• Plans for remembrance. They may have requests for carrying out their memorial service and managing their physical remains.

What can you do to help when the end of life is near?

It can be scary and painful watching your loved one go through this final phase of life. Knowing what to expect and how you can give them comfort can help.

When they’re entering the last days of life, you might see:

• Breathing changes. Breathing can speed up or slow down. There may be long pauses between breaths. There could also be rattling sounds because of mucus in the throat. To provide relief:

  • Add humidity to the room with a cool mist humidifier.

  • Help your loved one get into any position that makes breathing easier. Do this by using pillows or raising the head of their bed.

  • Turn them onto their side to help drain mucus from their mouth. Clean their teeth and mouth with water and a soft toothbrush or foam swabs.

• Skin changes. Skin is colder in the arms and legs. It and may turn blue or blotchy, especially in the hands and feet. To help:

  • Keep them warm with blankets or light bed coverings. Don’t use electric blankets.

  • Use gentle massage to improve blood circulation.

• Dehydration. Their mouth and lips may be very dry. They may also pee less. To help relieve dehydration:

  • Put a lip balm on their lips.

  • If they can swallow, give them ice chips or sips of liquid with a straw. Don’t force fluids.

• Confusion. They may not know what time it is, where they are, or who people are. To give comfort:

  • Remind them of the time, place, and who is present. Speak in a clear, calm, gentle voice.

  • Try to avoid making sudden noises or movements so you don’t scare them.

• Loss of bladder and bowel control. This could be due to treatment. Or due to loss of muscle function. To make them comfortable:

  • Have a healthcare provider insert a catheter to collect pee . Or put disposable waterproof pads under your loved one and change them often.

  • Give your loved one a sponge bath if they can tolerate it. Or wash certain areas.

• Pain gets worse. You may see them become restless. Or they may let you know that pain is getting worse. To give relief:

  • Help them take their pain medicine until the end of life. Help them with breathing and meditation exercises to reduce pain. You may also apply hot or cold packs. But wrap them in a thin, clean towel first. Don’t put them directly on the skin.

  • There are special types of massage to help reduce pain in people with cancer.

• Weakness. They can’t get out of bed and have trouble moving in bed. To help:

  • Help them turn and change positions every 1 to 2 hours. Try to time any position changes to be 30 minutes after pain medicine is given.

When should you call for help?

There will be times when you need help from your loved one’s healthcare team. It’s OK if you don’t know how to handle a situation. You may also feel too sad or afraid to be with them and may need a break. You can also call for help if your loved one:

• Has fallen or has a seizure

• Has pain that isn’t helped by their prescribed medicine

• Has new symptoms or a flare-up of old symptoms that were under control in the past

• Has trouble breathing and looks upset

• Has a sudden change of consciousness

• Is unable to pee or poop

• Has trouble taking medicine from you

Remember to take care of your own health during this time. You’ll be better able to cope with your grief if you prepare yourself for the changes that they’ll go through and do your best to comfort them during their final days.