Providing terminal illness support is going to be tough. No matter how the diagnosis reached this point, now that you all know its the end game its going to change things.
But how did the diagnosis reach this point? That’s one of the keys to dealing with terminal illness, cancer included, and it would be great to know the doctor’s reasoning.
The term “terminal illness” is used when a disease has passed the point of being curable or never was; its a disease that cannot be treated to any probability of success. The illness is concluded to be deadly, and hence terminal. It is a doctor, hospital or hospice opinion based on medical fact and experience. The only treatment that is considered to work is that given reduce suffering. Reducing pain through medication or other means, and providing a mechanism to make breathing easier.
Terminal cancer is another form of illness. The body cannot any longer medically fight the disease and is considered to be on a downward slope. But will a terminal patient accept this or will they fight? Is fighting adequately coping with terminal illness or is it delaying the inevitable? Only the patient knows, and it really does depend on them and their illness. Spiritual help may be sought or ignored, aggressive treatments may be brought into the picture, diet may be changed and alternative remedies tried.
A whole range of coping mechanisms come into play, and it is your duty as a carer to support these or calmly, coherently reason with the patient about their options.
You know yourself, or your friend or family member who is a patient. How will they come to the end of their illness and life? Will it be with relief from the escape of illness, or with a long list of regrets and incomplete tasks? How will a “good death” be defined?
Will it be with effective pain management?
Will it be with a look at death as final or with a spiritual afterlife?
Will it be through resolution and acceptance of past mistakes, and a plan for family’s and friends’ futures?
At some point you will need to talk about how the end will be approached. A terminal illness, cancer especially – depending on the type, is likely to shut down vital organs first. Will the patient sign a DNR – refusing to be resuscitated? This order demands a very precise method of preparation, and may change state to state, it is best to consult your medical and legal practitioners.
The diagnosis of terminal illness carries a hefty weight. The patient, family and friends all have to make a concerted effort to remain optimistic, even while planning for the end. This dichotomy is going to take its toll.
All you can do is provide support and guidance. Family and friends will do a lot to provide terminal illness support in the days ahead.