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Nearing End Of Life From Breast Cancer

Overview

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No one knows what will happen to any individual or when until it happens - even with metastatic breast cancer that appears to be at an end stage. 

Still, while it may be painful to think about, it is inevitable that at some point we all die. As wonderful as modern medicine is at prolonging life, it has not yet been able to overcome death.

Unless the end of life is very near, no one knows the future.

  • Predicting how long someone will live is not exact. Every patient is different. 
  • Some patients live long past the time the doctor first predicted. Others live a shorter time. Also, an infection or other complication could happen and change things.
  • Your doctor may know your situation best, but even he or she cannot know the answer for sure even when taking into account your type of cancer, treatment, past illnesses, and other factors.
  • In truth, none of us knows when we are going to die. Unexpected events happen every day.
  • The best we can do is try to live as fully as we can today - and prepare "just in case".

Your Choice: How You Live

It is your choice how to live the remainder of your life. You can have hope, look for joy and live each moment while you can. You can just lie down and let go. Or you can live anywhere in between.

No matter how certain things seem, you can still have joy in your life. There is always reason to hope.

It helps to look for humor - even if it is watching old I LOVE LUCY reruns. Laughter can help you relax. Even a smile can fight off stressful thoughts.

Your Choice: Medical Care

Just as you have control over how you live, you also have the ability to control the last period of your life.You can request good medical care until your last breath.

As a practical matter, It is your choice whether to keep trying to control or eliminate your breast cancer, to choose no treatment except pain relief, or to choose an in-between path. It is also your choice how much of your personal and financial resources you are willing to spend and for how long. It is even your choice how to make the decision. If it comes to that, there is also the option to have terminal sedation so that the end of life is painless.

If you want to assure you will be able to stay in control of medical decisions even if you become unconscious or unable to communicate, or if your lose your mental ability, execute the legal documents generally known as Advance Health Care Directives and Advance Directive For Mental Health

Writing legal documents about events that could happen is not going to make them happen. The documents and discussions that accompany simply make it more likely that you will get the care you want and that you won't receive the treatments you don't want. Just executing the documents can bring peace of mind.

Whatever you decide now:

  • Whatever you decide, you can change your mind as often as you desire.  Advance Directives can be revoked or revised on a moment's notice.
  • There is no reason to live with pain. Do not be afraid of becoming addicted to pain medication. It is not common in this situation. If your doctor is not aggressive about reducing or eliminating pain, you can bring in a doctor who will provide such care. Don't be surprised if one of the suggestions for reducing pain is palliative radiation (radiation whose goal is pain control instead of a cure), chemotherapy or surgery.
  • To be sure to get the medical care you need, see Managing Your Medical Care.
  • Let your medical team know your wishes about continuing medical care. If you don’t feel strongly about wanting or not wanting specific treatments, you can tell your medical team your general wishes. They can fill in the blanks as needed.

An Alternative To Consider: Comfort Care (Hospice)

If you decide comfort is your goal rather than continue to fight the disease, care known as hospice care is available.

Hospice care provides physical and emotional comfort to you and your family in a variety of settings, including in your home.

Hospice care is generally available for free if necessary.

Terminal Sedation

If end of life is near and you want to be relieved of pain and anxiety, terminal sedation is an option to consider.

Home Care Is Available

Medical and personal home care is available if needed. There are even doctors who make house calls.

Home care is generally covered by health insurance. If it isn't, you can save money by hiring health aides yourself instead of using an agency. Organizations to which you belong, including religious organizations, may be able to provide volunteers to help.

Tell People About Support You Need 

Let your family and friends know about what support you need, including chores or activities you have difficulty doing. Do not make them guess. They cannot read minds.

Talk about your emotions. In addition to the people closest to you, consider speaking with a clergy person or spiritual guide. Professional help is available if you want.

Talk About Your Emotions

In addition to the people closest to you, consider speaking with a clergy person or spiritual guide.

You can likely find people in a similar situation in support groups (which are available on line and on the telephone in addition to in person). If it better suits your personality, look for a cancer buddy.

Professional help is available if you want.

Get Your Affairs In Order

If you haven't already, it is wise to get your affairs in order now. At the least:

  • Make plans for your children so they are taken care of if you become incapacitated or die.. 
  • Everyone should have a Will. (Actually, everyone has a will. If you don’t have a valid one, the state you live in fills in the blanks for you. Is that what you really want?)
  • Consider putting together an Ethical Will.  An Ethical Will passes to your heirs information they should know such as your family history, what you learned in your lifetime, and whatever else is important to you. You can create this legacy in whatever way is easiest for you. For instance, by writing a letter, or by putting together a scrap book with annotations.

If you have made plans, review them to be sure they are still what you desire.

If you want to save your heirs unnecessary expense and stress, consider pre-planning your funeral. Pre-planning is different than pre-paying. Survivorship A to Z provides practical information about planning and saving money on a funeral. 

How To Assure Visitation From A Partner

If you are part of an unmarried couple (heterosexual or homosexual), it is advisable to take steps now to assure your partner will be able to visit if you end up in a healthcare facility. For instance, appoint him or her your Health Care Proxy under a Health Care Power Of Attorney to make medical decisions in case you can’t. (See "To Learn More.")

Leaving the planet early

If you want life to end before nature takes its course, speak with your doctor. Most deaths in this country are negotiated between patients and their doctor. As an alternative, while we do not recommend it, there is also the possibility of assisted suicide and ending your own life.

As an alternative, while we do not recommend it, there is also the possibility of assisted suicide and ending your own life.

Finances

If you haven't before, this is a good time to consider at least turning over financial matters relating to your health care to a family member or close friend. In any event, the following articles help maximize your financial situation or show you how to qualify for Medicaid.

Someone to speak with about these subjects

If you prefer to talk with someone about these issues other than your immediate family and friends, speak with your social worker or other mental health therapist, people in a breast cancer support group, a member of the clergy, or contact the American Cancer Information Center twenty four hours a day, seven days a week at 800.ACS.2345.

For more information, see: 


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