Constipation can also be caused by the disease itself as the tumor grows and affects different organs. Diet and decreased activity can make it worse. There are many over-the-counter medications that treat constipation, such as stool softeners and laxatives.
Ask your healthcare provider what medication to take and how much. You may need a prescription for a stronger medication. Try to drink liquids, if you can, including water, juices, soups, and ice cream.
You can also talk with your clinical nurse dietitian about foods that might help with constipation. Diarrhea is loose and watery bowel movements. At the end of life, both the disease and its treatment can cause diarrhea.
Your healthcare provider may encourage you to drink more liquids to help prevent dehydration. Drink clear liquids, such as apple juice, water, broth, and ices.
Try sucking on ice pops. Avoid milk and other dairy products. Eat frequent, small meals whenever possible. There are products available for adults who are active even with having diarrhea. You can find these products in your pharmacy and some grocery stores.
They include:. Wash the area with gentle soap and water. Apply ointment after each bowel movement. Ointments you can use include:. You may have a feeling that your food is stuck in your throat, which may make you cough after swallowing. This can cause aspiration when food gets into your lungs. Aspiration can cause pneumonia lung infection. These symptoms are more common in people who have cancer in their chest or neck.
Tell your healthcare provider if you have these symptoms. In that case, you may need IV hydration. The time leading to death can be very difficult. Feeling sad and anxious is normal and expected. If you feel that depression and anxiety are interfering with most areas of your life, talk with your healthcare provider.
Sometimes it may be your loved one who is depressed or anxious. Ask your doctor, nurse, or social worker for support services available for caregivers or read Caregiver Support Services. Depression and anxiety can be treated with talk therapy, medication, or both. Talk with your healthcare team about how you feel so they can help you. Our counselors provide counseling for individuals, couples, families, and groups, as well as medications to help with anxiety or depression.
Fatigue is feeling unusually tired and weak. It can range from mild to severe. Fatigue can also make other symptoms worse, such as depression, sadness, and feelings of loss. All of these are common at the end of life. Ignoring or trying to take the pain may cause stress and make your fatigue worse. Nausea and vomiting are symptoms that may occur at the end of life. Nausea may begin as an unpleasant feeling, like being motion sickness.
It may or may not cause you to vomit. Controlling pain is a big part of your cancer care and is very important at the end of your life. Take your pain medication as long as you can and on a regular schedule. If you have trouble swallowing your pills, the medication can be given in other ways.
Some people may have procedures, such as palliative radiation therapy or nerve blocks, to relieve pain. Palliative radiation therapy is given to help with symptoms, not to cure the cancer. It can also be used to shrink a tumor that causes pain by pressing on nerves. Talk with your healthcare provider. Some people worry that taking a lot of pain medication may cause addiction or speed up death. Other people are worried about the side effects from pain medication.
Tell your healthcare provider if you have these concerns. This includes aggressively controlling your pain while reducing the side effects of medications. Shortness of breath is common at the end of life. It can occur in people with any cancer at the end of life. There may be more than one cause of your shortness of breath. Shortness of breath can be different for everyone. You may only become short of breath when climbing stairs or you may experience it when at rest.
It can be treated. You may get medication to relax the muscles in your airways or pain medication to help with the feeling of breathlessness. Oxygen can help make it easier to breathe as well. There are many ways to improve this symptom. In the last hours of life, you may have a rattling sound in your breathing. This happens because saliva or fluids collect in your throat or upper airways.
This is called terminal secretions. You may be too weak to clear them. It may not make you uncomfortable, but it may worry your family and friends. They can change your position to see if that stops it. They should avoid suctioning because it can cause discomfort. Your body temperature may become cooler.
Breathing may become shallow. A sigh may be followed by a period of no breathing. This pattern will continue for some time, often hours. Your skin color may change and become paler or grayish. The circulation in your hands and feet will decrease and they may become cool to touch.
During the last hours of life, you may not speak and may seem to be in a coma or sleeping. But, you may still be able to hear voices. Talk with your healthcare team about any questions and concerns you and your family may have. Death is different for everyone.
Our goal is to help you and your loved ones through this time with comfort, peace, and dignity. Last Days of Life www. Transitional Care Planning www. Your feedback will help us improve the information we provide to patients and caregivers. We read every comment, but we're not able to respond. If you have questions about your care, contact your healthcare provider. For more resources, visit www. Back to top Palliative Care Palliative care is a medical specialty that focuses on improving the quality of life for people with a serious illness through symptom management and emotional support.
The goals of hospice are to: Help you live comfortably at the end stage of your life. Help you and your family cope with the changes that are happening. Help you have a peaceful death. You can get hospice care in different settings, including: At home In an assisted-living facility In a nursing home In a long-term care facility In a hospital that specializes in palliative care for people with cancer Hospice care may be paid for by Medicare, Medicaid, or private health insurance.
Back to top Other People Involved in Your End of Life Care Many other specialists are important in making end of life care as peaceful and meaningful as possible. Social workers Social workers provide emotional support and counseling. Your social worker can also: Provide emotional support around issues such as change and loss. Identify specific concerns that you or your family have.
Prepare you and your family for your death. Help your family and healthcare team communicate. Provide referrals to bereavement or support groups and community resources. Counsel family members, including children. Case managers At MSK, case managers are registered nurses. They help you and your family with discharge planning, including: Arrange for services such as home care, home hospice, or placement in a care facility as needed.
Arrange for nursing visits, physical therapy PT , and social worker visits, if these are needed. Arrange for medical equipment, if needed. Help you find out what will and will not be covered by insurance. Chaplains Spiritual and religious concerns may come up during a serious illness and as you near the end of your life. Chaplains are available to: Listen to your concerns about illness or hospitalization without judgment.
Help support family members experiencing feelings of grief and loss. Provide you with a comforting presence. Help you with end-of-life decisions. Pray, meditate, or join in ritual with you. Contact community clergy or faith groups for you. Integrative Medicine Our Integrative Medicine Service offers therapies that can complement go along with your other care. Physical and occupational therapy A physical or occupational therapist can work with your family members.
Your therapist can teach your family how to: Position and turn you in your bed and chairs. Adjust your position to make you comfortable. Help you transfer safely from bed to chair or from bed to commode. Do passive exercises for your arms and legs.
These can help you maintain some strength. Back to top Open Communication Coping with cancer is difficult. Back to top Help for Children Who Have a Loved One with Cancer The diagnosis of a loved one with cancer affects every member of the family, especially children.
Back to top Nutrition Advanced cancer can cause issues that can affect your appetite and eating. You may feel safer if you have a walker or wheelchair. Your doctor or hospice team can help you get the equipment you need to be comfortable and safe. If you're shaky, don't use sharp utensils or other things that might cause injury. If you're able to drive, be careful to not drive when you are feeling fatigue. Plan activities around the times you feel the best and have the most energy. Sit outside, listen to music, go for a ride in the car, spend time watching a meal being prepared — distractions and stimulation of your senses may help ease fatigue.
Plan rest periods when you are out of bed so that you can sit to regain energy. Take short rests during activity. Keep chairs close by so you can sit down right away without using extra energy.
Fatigue can also make you sleep more. Needing more sleep is often normal in the last stage of life. It's also common to withdraw from people, turn inward, focus on yourself, and talk. Although some people want to surround themselves with friends and family, others may want a quiet, peaceful environment.
Listen to your body, be sure to tell people what you need, and try to save your energy for the things or people that are most important to you. Focusing on getting the most from each waking moment is a good way to redirect your worries and fears. You can learn more in Cancer-related Fatigue. People with cancer often have pain, and often fear it will get worse. Cancer pain is considered to be chronic pain because it usually lasts longer than pain caused by other problems.
Pain can make you feel irritable, sleep poorly, decrease your appetite, and decrease your concentration, among many other things. While pain can't always be completely relieved, pain can be controlled and managed.
Pain does not have to be a part of dying. You and your health care team must work together to reduce any suffering due to pain and enhance your quality of life. You should talk to them about your pain and develop a pain control plan together. Talk to them at every visit, and call in between visits if something is not working or your pain gets worse. Your health care team understands that pain is different for everyone, and your pain is whatever you say it is.
You should expect that your pain can and will be controlled. If it isn't being controlled successfully, you may want to ask your team to refer you to a pain specialist.
When you report your pain, it's best to describe it in as much detail as you can, including:. Keeping a record of all of this in a pain diary may help. Often your health care team will ask you to describe your pain using a number from 0 to 10, with 10 being the worst pain you can imagine and 0 being no pain at all. Using this pain scale is also a helpful way to describe your response to pain relief measures.
The nurse or doctor will assess your pain and figure out the average level or degree of pain you have. There are a lot of different types, forms, and doses of pain medicines available. For instance, certain anti-depressants or anti-convulsants seizure control drugs often work well to help with nerve pain. Steroids may be used to help with certain types of pain, such as that caused by swelling or inflammation.
These medicines are often given along with the opioid drugs. This will also help you better communicate with those close to you. After receiving a terminal cancer diagnosis, your doctor might be the last person you want to talk to. But these questions can help start a dialogue about the next steps:. How someone proceeds after receiving a terminal cancer diagnosis involves a good deal of personal preference. These decisions may be incredibly difficult, but going over these questions with yourself may help:.
What you decide to share about your diagnosis is completely up to you. Here are some discussion points to consider:. Thanks to the internet, there are a lot of resources that can help you navigate the many aspects of a terminal cancer diagnosis. To start, consider finding a support group. These groups are designed to bring together individuals, family members, and caregivers coping with a cancer diagnosis. They can provide you, as well as your spouse, children, or other family members, with compassion, guidance, and acceptance.
The Association for Death Education and Counseling also offers a list of resources for many scenarios involving death and grief, from creating an advanced directive to navigating holidays and special occasions.
CancerCare also offers a variety of resources for dealing with terminal and advanced cancer, including educational workshops, financial assistance, and expert answers to user-submitted questions. You can also check out our reading list for coping with cancer. As a society, we expect too much from people fighting cancer. We need to stop. Though grief is normal in people with a terminal illness who are facing the end of life, it can evolve into depression. Learn about symptoms and…. Grief is a process.
It comes in stages. There may be a denial, there may be anger, and these feelings may come separately or all at once. But, death…. You're Going to Die is a poetry and prose event in San Francisco. Read the story behind this event in an interview with founder Ned Buskirk.
Our feelings can affect how we handle situations and how we run our lives, so we put together a guide to help you build awareness for a more…. Research on whether talcum powder causes cancer is mixed, with some studies demonstrating only a small increase in risk of certain cancers.
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