Caring for a Person with Terminal Cancer
When a person is dying of cancer, the goal of care is providing as much comfort as possible. Often a change is made from a focus on cure to a focus on comfort care. This means providing comfort with the least invasive procedures, while maintaining privacy and dignity. A person who is dying of cancer has many needs and those caring for them should respect their personal wishes.
Routine for sleep and rest
Lack of sleep may be caused by many reasons. These include visitors, discomfort, fear of not waking up, loneliness, restlessness, or day and night confusion. Keep a night light on and a clock in the room. It's also helpful to have a way to communicate, such as a bell or 2-way voice intercom in the room, or both. This may help the person if they are woken up and confused.
Nutritional issues
Nutritional issues may be hard to address. Nausea, vomiting, diarrhea, constipation, and eating less often go along with the effects of treatment and the progression of the disease. Loss of appetite and weight loss are often a normal and natural part of the dying process. Let them eat whatever they want, whenever they feel like it. Offer small amounts of food if they enjoy it. If the person has trouble swallowing, don't give them solid food. They may enjoy milkshakes, pudding, or ice cream. You can try sips of liquid if they're interested and use a flexible straw. Try not to force them to drink fluids. Once a person can't swallow, offer ice chips, and keep their lips moist and mouth clean.
Changes in bowel or bladder control
A seriously ill or dying person may have diarrhea, constipation, or incontinence. Care should be given to keep the person's skin clean and provide a clean environment. Losing bowel or bladder control can be embarrassing for the person. It's important to maintain their dignity and minimize embarrassment. Put disposable pads underneath the person. Give them a sponge bath or use wipes to clean soiled areas of their body.
Skin care
Various things can cause skin breakdown, pain, or both. Infection may occur in this case. The health care provider may talk with you about what ointments to apply and about giving the person antibiotics. To prevent skin breakdown, keep the skin protected and help the person turn and change positions every 1 to 2 hours.
Respiratory changes
Respiratory changes may happen from a lung infection (pneumonia), the effects of pain medicines (opioids) , or the disease getting worse. Often people will feel they can't catch their breath. This is called air hunger, and it can be scary. Less oxygen in the bloodstream may also cause a seizure. The person may need oxygen given through the nose or by a mask. A simple fan aimed at the person may help ease the feeling of breathlessness. Or help position the person in any way that helps their breathing. Sometimes medicines can also ease anxiety related to breathing problems.
Managing discharge
Discharge from the nose, mouth, and throat may be hard to manage. Suction devices are available to remove the fluids. It may also help to put the person in a different position to help drain the extra discharge. Medicines can help reduce the amount of discharge. Clean the teeth and mouth with a soft toothbrush or foam swabs.
Managing pain
Every step should be taken to minimize pain from the dying process. Managing pain with medicines and other measures should be discussed before the person has a lot of pain. It's important to understand that the ultimate goal is comfort. Pain management is an important topic to discuss with the provider.
Changes in circulation and temperature
A person's arms and legs may become cooler during the dying process. Their skin may look blue and blotchy. This is called mottling. Keep the person warm with blankets. Don't use electric blanket or heating pads. They could cause burns.
When death occurs
The person's breathing and heart will stop. Their muscles will relax. They may lose control of their bladder or bowels. Their eyes will stop moving and may stay open. The person won't respond to being spoken to or touched. Their skin will be cool to touch. You may want to simply sit with the person. Some people find it helpful to pray, talk quietly, or hold their hand. If the person has home care or hospice staff, notify them that the person has died. Also notify the person's provider and funeral home.