Even with all the advancements in cancer treatment, sometimes cancer cannot be treated or managed successfully. At some point in your cancer journey, you may need to consider end of life care. According to studies, patients who discuss end of life care with their healthcare team tend to have improved quality of life and to enroll in hospice care at the most beneficial time. So, what needs to be considered when discussing end of life care?
How can you make sure your medical wishes are carried out even if you are very ill? Advanced directives or an advance care plan are legal papers that tell your family and healthcare team your medical wishes. They are used in case you cannot make a medical decision. For example, if you are unconscious, your healthcare team and family will follow your advanced directives.
Advanced directives may include living wills, medical power of attorney, or DNR orders. Your hospital or treatment center can give you the forms. Be sure to give your family members and healthcare team a copy of your advanced directives. If you change your mind about the kind of treatment you prefer, you can change your advanced directives.
Palliative care is a treatment or strategy that helps improve quality of life for patients but does not provide a cure. Palliative care many also be called supportive care or symptom management. Examples of palliative care include:
- Physical therapy
- Nutrition therapy
- Deep breathing techniques
- Radiation, chemotherapy, or surgery to shrink tumors that are causing other symptoms
- For example, tumors that have metastasized to bones and continue to grow may cause fractures. A tumor in the esophagus may cause difficulty swallowing. Radiation may offer relief for both of these issues.
- Medications, such as pain medication
- Emotional support, such as meeting with a therapist or support group
Some forms of palliative care may be covered by insurance. Sometimes costs for palliative care fall on the individual.
Note: A patient does not have to be terminal to receive palliative care. Palliative care can also be combined with forms of curative treatment to help patients manage side effects or symptoms.
Specifically, hospice is end of life care. Patients with a life expectancy of six months or less often use hospice. Enrolling in hospice can help keep patients more comfortable and prepare them for end of life. Hospice is very individualized to address the patient’s specific needs. Hospice care may be provided at home or in special facilities such as hospitals or nursing homes. Members of a hospice care team may include:
- Home health aids
- Social workers
- Physical/occupational therapist
- Counselors and/or clergy
Hospice care is beneficial not just to patients but for caregivers as well. As a patient reaches the end of life, the caregiver may not be able to provide the level of care required. Additionally the hospice team will keep the caregiver informed on what to expect and can provide the caregiver with resources for emotional and spiritual support for losing a loved one.
Medicare pays for all hospice costs. In most states, Medicaid pays for hospice costs. Most other insurance plans have hospice benefits.
Although end of life care may be difficult or scary to consider, it is best to discuss these issues with your healthcare team and loved ones early. You will not want to deal with them when you are feeling very ill, but you will want to insure that your wishes are carried out and that you maintain the best quality of life possible.