Expert: Margot RN BScN CGN - 10/19/2009

Question
Hi Margot,
My Aunt was diagnosed with Breast Cancer 10 years ago - went thru Chemo %26 radiation %26 had a double mastectomy... and her cancer went into remission. Last May, doctors found a tumor on her sternum... bone cancer - and estimated her lifespan at 2 years. In August, she developed an infection in her lungs, which a doc in a box treated with antibiotics %26 gave her something for the pain. She recently returned to her home in CA, and had a PET scan which showed fluid in her lungs due to the bone cancer. She sleeps 20 hours a day, and has hospice coming to her home 2 or 3 times a day. When she sleeps, she has an oxygen tank now too. I am going down to her home in 12 days to spend time with her, and give my Uncle a break for a week. I know no one can answer the question - do I have that long... and I guess my biggest question is - should I let her bring it up, should I, I just don't know how to deal with saying goodbye! I mean, she knows she is dying, but she's always been so strong and I am terrified that I might make her sadder than she already is. My family says I shouldn't cry around her, but jeez! How do you do that? I don't expect I'll break down in hysterics... but I think letting a little emotion out is appropriate - I am really, really sad..! Is it inappropriate to talk about your feelings with a close relative that is dying?

Answer
Hi Melissa and thanks for writing,

You’re right that no one can guess “how long”, really her oncologist would be the best person to give an accurate prognosis.  I can suggest that if she makes Thanksgiving it will be her last and Christmas is doubtful.

As far as what to talk about, I would leave it up to her and always try to be honest and don’t be afraid to ask open questions like “how is Uncle Joe coping” or “is there anything I can do for you that you want but don’t want to upset him with”.  If she’s not the type who has been in denial most of her life or didn’t like to discuss unpleasant topics when she was younger, then there’s no reason to avoid or be afraid to discuss her current situation with her IF SHE wants to.

Ads for crying, I wouldn’t walk in weeping the first minute you see her, but if you two do have a heart-to-heart then tears are normal and natural. And she may well need someone she can be honest around.  It’s not uncommon for people to try to hide their fears and tears from souses or children and may really want someone who’s shoulder they can lean on.

Just follow your heart, this may be your last visit of any quality.  Too many people focus on being at the bedside for the final hours, but by that time the person is usually unconscious and completely unaware of where they are or who’s at their bedside.  In my experience the visits that really count are the ones that occur when the person is still aware of their surroundings and able to communicate. It sounds like this is the perfect time for you to spend time with your Aunt and give your uncle some support and respite.

My thoughts are with you all,
Margot