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Palliative care versus treatment- should one try to influence?

(35 Posts)
kittylester Tue 27-Aug-19 14:14:07

A longstanding friend of dh has throat cancer. She is saying that she is going to accept palliative care rather than the life changing treatment on offer.

Her husband and daughter have called on various friends, including dh, to try to change her mind.

Should they?

Teetime Tue 27-Aug-19 14:19:44

I think its unfair to put pressure on anyone in this situation. Far better to leave it to the person concerned to make up their own mind based on the information they are getting from their clinicians and possibly one very close loved one e.g. the husband. Poor lady she needs peace of mind at this stage not conflicting opinions.

tanith Tue 27-Aug-19 14:20:53

It’s really her decision to make but I understand their motivation. Not an easy decision for anybody involved.

jura2 Tue 27-Aug-19 14:23:45

Totally agree Teetime - I would wish my loved ones to accept my decision.

As you know, my choice, and available to me here in Switzerland- would be to make the very best of the quality of time left, then go. OH knows, kids know- they know that if ever I have to make the choice, they have to respect it.

If only people talked- couples, children, brothers and sisters - in advance, when all is well - about wishes in case.

SisterAct Tue 27-Aug-19 14:23:49

Completely agree Teetime. My mum decided no more blood transfusions and although desperately sad we had to let her choose. Friend at the moment has chosen treatment if at all possible. It has to be patients choice.

FlyingSolo Tue 27-Aug-19 14:31:00

Do you know what the medical advice is? How likely is the treatment to be successful if she accepts it? There may be good reasons why she has chosen palliative care. If there are good reasons and the doctors think her choice is reasonable it is unfair to spoil what time she has left by making her feel guilty. However if treatment is very likely to be successful and the side effects and risks of treatment aren't too great then the people who are going to grieve for her will eventually take comfort from knowing there was nothing more they could have done to encourage her to accept help. I think your dh has been put in an unfair position but I can understand why the husband and daughter have done this. Such a difficult time for everyone.

varian Tue 27-Aug-19 14:36:46

I also have a friend in this situation who is opting for palliative care only. Her husband and family accept that it is her decision, but I know it can't be easy for them to accept. Her death will come sooner but they hope she will suffer less.

It is very difficult for friends to know what to say to her. I am, and at the same time am not, looking forward to visiting her but I am worried I might get it wrong.

tanith Tue 27-Aug-19 14:45:49

varian last year when my husband was very ill he was glad to see visitors and enjoyed reminiscing with his brothers and friends but I suggest keeping your visit short as it can be very tiring.

MissAdventure Tue 27-Aug-19 14:51:04

I think it's terrible to try and pressurise someone on such an important and personal decision.

Unless anyone has walked in her shoes (which of course, they haven't, because everyone's experience is different) then I think its an awful thing to do.

NanKate Tue 27-Aug-19 15:05:58

My friend chose palliative care and enjoyed her last months.

My son’s MinL was persuaded to go for treatment and her last months were absolutely dreadful. I visited her just before the end and was shocked to see the person she had become. I told my son never to let me get to this state.

This is just my experience but I know what I would opt for without a doubt.

jura2 Tue 27-Aug-19 15:11:26

My best friend had pancreatic cancer- her husband just could not let go and took her from expensive specialist and private clinics- more and more invasive treatment. she did not want it - it made her last few months an absolute misery- she wanted him to spend time with her talk, hold hands, cuddle ...
She was a member of Exit (similar to Dignitas- but in your own home) - but she died in a posh clinic, where she did NOT want to be.

kittylester Tue 27-Aug-19 15:24:09

Dh knows someone who has been through a similar thing and has agreed to talk to her if she wants to call him. She has said she will. She had a previous experience of having breast cancer 20 years ago which I think might be colouring her thinking.

nightswimmer Tue 27-Aug-19 15:45:56

I hope they respect her wishes.

Sara65 Tue 27-Aug-19 16:05:12

Oh how difficult.

Of course she must be allowed to make her own decision, hopefully with the support of her family, but obviously they want her to try everything she can, even if there’s just a glimmer of hope, I feel for all of them.

Baggs Tue 27-Aug-19 16:06:52

Her life, her choice.

kittylester Tue 27-Aug-19 16:43:40

I agree baggs but how to say that to her family. Dh has done a good thing, I hope

Galen Tue 27-Aug-19 16:46:36

Bags my thoughts precisely

trisher Tue 27-Aug-19 16:53:59

kittylester Have the family been in touch with Macmillan? They offer counselling to the families of cancer patients and I am sure they would discuss this properly with them. I know a few people who have used them and they have all been helped through difficult times.

Stansgran Tue 27-Aug-19 17:04:59

A dear friend chose no more treatment. Her family supported her knowing her for the intelligent woman she was. I am very proud to have known her.

Auntieflo Tue 27-Aug-19 17:06:07

I think that sometimes, a person has just had enough.
My DH and I have both had cancer this last year, and although we are 🤞OK at the moment, we have both said that if any other life limiting illness came along, we would just prefer to be made comfortable, and not have invasive treatment.
Sometimes the 'cure', can be worse than the disease.
DH is 80 and I am 77, so far we have had good lives and wouldn't like to prolong them for the sake of a few months or so.
The decision has to be left to the patient to make their own choice.

sodapop Tue 27-Aug-19 17:09:02

Yes of course it's her choice and I understand why your friend feels like that kittylester
However her family must feel devastated by this decision. I think her family should ensure she has all the relevant information before things are finalised.
Sometimes the kindest thing is also the hardest.

grandtanteJE65 Tue 27-Aug-19 17:11:14

Such a sad and difficult situation.

My own feeling is that your friend has the clear right to say she only wants palliative care but I do realise how distressing that decision must be for her husband and daughter.

If the prognosis is that she is terminally ill, then I feel you should try to support her in her decision. To her husband and daughter, you should perhaps just say, if they mention the matter, "I am afraid I am in complete agreement with N, but I do realise why you find her decision hard to accept."

Please do not allow yourself to be drawn into trying to change your friend's mind. If you know her husband and daughter really well, you could gently point out that with any incurable illness there comes a time when the patient realises that she will not recover and should be allowed to die as peacefully and painlessly as possible.

This is shatteringly difficult to accept, but I know from the terminal stages of my sister's illness that it has to be faced.

You have all my greatest sympathy.

Baggs Tue 27-Aug-19 17:20:49

I would say just that (her life, her choice) to the family, kitty, and, if necessary, expand on that to the effect that wanting someone to stay alive when they don't want to could be seen as cruel. Medical treatment and care is not just about saving or prolonging life. Just as importantly it's about reducing suffering. Sometimes death is the only satisfactory way to reduce suffering.

This is my opinion and I don't think beating about the bush and not being direct helps anyone.

petra Tue 27-Aug-19 17:41:51

My sister stopped all treatment for her cancer. She was advised that she would only have another 6 months.
She lived another 3 years. Her quality of life in that 3 years was good, infact most people didn't know she had the disease.
It wasn't until the last 3 months that she needed palliative care.
I believe it has to be that persons choice.

wildswan16 Tue 27-Aug-19 17:52:43

Her choice entirely. Treatment may help, but will also reduce the quality of time she has left both for her family to enjoy her presence, and for her to enjoy theirs.

Friends and relatives need to try to think about it from the "patients" point of view, rather than their own sadness at the thought of loss.