The physical and emotional problems you may experience with advanced
cancer are best handled by skilled doctors, nurses, social workers,
and other health-care team members working together with you and your
family. People often think that someone with advanced cancer must be
hospitalized to be comfortable. Fortunately, the hospice movement has
resulted in more and more people being cared for in their homes. Most
hospice programs require that a person have a "primary caregiver,"
which means that one or more family members are available to provide
care. Family members can be taught to do things like give medication,
provide catheter care, or prepare and apply dressings. While this may
seem frightening at first, the hospice nurse will work with family
members until they are comfortable doing these things. The hospice
nurse will visit your home frequently to be sure that you are
comfortable and will communicate with your doctor about any problems
that may develop. Caring for someone with advanced cancer can be
difficult, which is why the hospice staff works with the entire
Sometimes people and their families cannot talk easily with one
another because of their fears about the future. If young children are
involved, they may be confused or resentful because the parent's
illness has interrupted their lives. With elderly couples, the spouse
of the person with cancer may have health problems that are being
neglected. The hospice nurse or social worker will address these
problems so that families can continue providing care and support for
their loved one.
HOW PHYSICAL CARE AND EMOTIONAL SUPPORT SERVICES CAN HELP
Provide pain management so that the patient is able to live
Provide help in how to treat and avoid skin problems caused by
being confined to bed.
Give advice about diet so that strength is maintained. If nausea
is present, medications are given to control that.
Provide help with bowel and bladder problems that can result from
side effects of medications, the illness itself, problems with
nutrition, or inactivity.
Provide emotional support and practical advice for family members.
HOW DO YOU FIND THESE SERVICES?
Talk with your doctor, nurse, or social worker to see if hospice
care is appropriate. If you are still being treated to cure your
disease, you are not eligible. However, people in hospice programs may
receive radiation or chemotherapy to control symptoms.
If your doctor is not aware of a hospice program in your
community, call the Hospice Information and Referral Service for
Pennsylvania, 1-800-658-8898. Also ask your local Visiting Nurses
Association if it provides hospice care, or ask your local American
Cancer Society for help in finding hospice care.
Hospice services are available from hospitals (usually they only
accept their own patients into their hospice program), home-health
agencies (Visiting Nurses Associations or private agencies), some
nursing homes, community-based programs, or, in rare cases, a special
institution that admits patients.
Occasionally a program will state that it delivers hospice care
when it really does not. Minimal requirements for quality hospice
programs are: (1) medical direction for symptom management; (2)
24-hour availability; (3) a team of professionals who will come to
your home; (4) bereavement and volunteer services. A general
guideline: Ask if the program is accredited by the Joint Commission on
Accreditation of Health Care Organizations (JCAHO) or if it is a
Hospice care is not for everyone. For example, some cancers are
medically difficult to manage at home and require hospital or nursing
home care. Some families are too upset to care for a person at home or
cannot provide this kind of care.
Sometimes people want to keep trying for a cure even when their
disease is in an advanced stage. If that is the person's and the
family's wish, it should be respected. Some families resent what may
appear to be an intrusion into their lives by a hospice team. This
feeling usually changes as people get to know one another. You are the
best judge of what is right for you or your family. If you are not
sure what would be helpful, talk it over with someone on your
Hospice care does not mean you are giving up on life. It does mean
that you want to be as comfortable as possible and enjoy the best
quality of life despite your advanced illness.
When people live with an illness for a long time, they often are
tired and the simplest problems may appear to be overwhelming. A
hospice program can offer important relief to families facing a
Uncontrolled pain is unnecessary. See PAIN
CONTROL for more information.
Jan 31, 2013 - Early palliative care clinic visits, integrated with standard oncologic care for patients with metastatic lung cancer, emphasize symptom management, coping, and psychosocial aspects of illness, according to research published online Jan. 28 in JAMA Internal Medicine.