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Original poster

Questions from dying MiL

43 replies

MamaToABeautifulBoy · 27/10/2023 13:04

I have posted fairly recently about my MiL who was given 6 months to live just over 6 months ago. I received some very supportive and helpful emotional / psychological advice which I’m so grateful for.

I am now seeking further, perhaps more medical based, advice. I asked my MiL if there is anything I can do to help allay her fears. She asked me to try and establish what signs she should look for when the time is near. She also asked me to find out whether she can expect to experience pain. Her original cancer was ovarian but has spread to her liver. She is 80.

She doesn’t want to ask her nurses directly as she fears they may be too frank. She is obviously terrified about the future. We all feel so helpless.

She doesn’t want to discuss this with DH or her other son or daughter or her DH. They are a ‘sweep it under the rug’ type of family.

Does anyone have any advice or experience of this utterly horrendous situation and what my MiL can expect over the coming weeks or months?

OP posts:

StrangePaintName · 27/10/2023 13:05

Is she at home? In a hospice? In my experience hospices are good with this kind of end of life care.

Ozgirl75 · 27/10/2023 13:11

My grandma died of cancer and she had primary breast that spread to the lung. She was scared of dying gasping for breath but it wasn’t like that at all.
Towards the end she was in a beautiful hospice and she just slept more and more. She would wake and sip water (or a gin and tonic!), have a couple of bites of food and then fall back to sleep. One morning, after around 2-3 days of minimal waking but being aware when she was awake, she wasn’t able to be roused in the morning (but wasn’t dead). She slipped away later that morning, extremely peacefully.
She was given pain medication and also I think Valium or similar and she wasn’t scared, worried or in any pain.
My parents were able to sit with her on her last day, my mum told her she’d been a wonderful MIL and that if she was ready to go, she should go and join her husband and brothers and sisters. The next day she died.
The hospice were amazing. It’s taken away a lot of my own fear about dying as it was very managed, peaceful, painless and calm.

Ozgirl75 · 27/10/2023 13:14

This was also very similar to a friend’s dad who died last year of stomach cancer. He went quite quickly as he was in his early 70s and it has spread all over. He had a very similar progression though of increasing sleep, minimal food and water and then died with his wife and children holding his hands. No pain, just slow breaths turning into slower ones and then drifted away.

VisaWoes · 27/10/2023 13:14

Both my parents died from cancer and I sat them with them at/near the end.

My dad died at home with disctrict and hospice nurses coming in to do the pain relief. So he had a morphine pump and also a hospital bed. The hospice provided people to come in 3x a day to change him and also someone to be with him in the night, this was for the last two weeks once he couldn't get out of bed. Prior to that he had been pottering around at home and not been in any pain. Those last 2 weeks he couldn't really talk, but I like to think he could hear us, he would squeeze a hand, etc. I think he was disorientated at times, I'm not sure about pain. Possibly, but he wasn't screaming in pain. but would be restless as he was due more morphine. But maybe the morphine just helped him sleep. We would read to him and talk to him. His breathing changed on his last evening and became more sporadic, he then just stopped breathing but it seemed quite peaceful.

My mum died in a hospice. I wasn't allowed in the hospice due to covid but had previously been with her (until her last week) in the hospital. So the week I was with her in hospital she was similar to my dad, sleeping most of the time and not communicating and not eating or drinking.

I'm sorry about your MIL. IME the nurses won;t really commit about pain, etc as everyone is different but they will try to be reassuring and say that there are drugs to help. I would recommend contacting your local hospice nearer the time and getting support from them. Also contact MacMillan.

NotLactoseFree · 27/10/2023 13:14

I am so sorry for you and your family. It's so difficult.

I cannot advise on this specific situation but I do know that palliative care for cancer is extraordinarily kind and that any pain will be managed with significant pain killers. It is far more likely to be a slip away situation than a dramatic painful active death if that makes sense?

Is she in a hospice or does she have hospice support?

Also, you could ask the hospice/hospital team and then "translate" for her as needed?

Ozgirl75 · 27/10/2023 13:15

Also, I don’t suppose she’s religious? My friend’s dad was a regular church goer and had a visit from the vicar on his last day - I don’t know what was said but they prayed together and I know that was of comfort to the family.

useitorlose · 27/10/2023 13:16

I know we don't reference the Daily Mail on here, but just yesterday there was an article about dying written by a palliative care doctor and it might be helpful for you.

SoupDragon · 27/10/2023 13:17

palliative care for cancer is extraordinarily kind and that any pain will be managed with significant pain killers. It is far more likely to be a slip away situation than a dramatic painful active death if that makes sense?

I agree. It was like this for both my parents. My mum appeared to be in a drugged dream when I last saw her.

CountryShepherd · 27/10/2023 13:17

I heard Dr Kathryn Mannix talking on Woman's Hour this week about the physical process of dying. She explained it so calmly, I found it very reassuring.

She has TED talks and books etc..

Mischance · 27/10/2023 13:18

Get the local MacMillan nurses, or those from a local hospice, to come and talk with her. They will have been present at many deaths, and will have helped people to die in peace. And they will have had this conversation with others. I am sure they would be able to help.

CountryShepherd · 27/10/2023 13:19

useitorlose · 27/10/2023 13:16

I know we don't reference the Daily Mail on here, but just yesterday there was an article about dying written by a palliative care doctor and it might be helpful for you.

Ah, that was Kathryn Mannix, she has a new little video on YouTube I think.

happysoul23 · 27/10/2023 13:25

Hi, I'm a palliative care nurse specialist.
I would urge her/you to discuss this with her team. They can give as much or as little information as she wants. They will deliver it in a kind, considered and gentle way. They will lie say more than she wishes to hear.
Ultimately there is no reason to suspect that pain with be an issue but if it is if she communicates this it will be dealt with

saraclara · 27/10/2023 13:27

My experience with my husband's death mirrors what many others have said. He was at home with us, had a morphine pump, and a Macmillan nurse and carers coming in each day. Sleeping more and more, eating less and less, not drinking, and then in the last hours his breathing becoming more sporadic and slower. Any pain was well managed, and he just eventually stopped breathing, with me, our daughters and the cat sitting with him.

It was so peaceful.

Chippychipsandgravy · 27/10/2023 13:33

Totally agree with looking up Dr Kathryn Mannix, her explanation about dying is beautiful and in my experience, spot on. I would advise trying to have your MIL admitted to a hospice for her last weeks. Hospice staff are far more aware of pain and pain relief. They can administer larger doses of morphine etc than hospital staff are allowed. The difference between my Dad's death and my Mum's was that Dad was in a hospice and was pain free during his last days. I wish I had known this for my Mum.

Odiebay · 27/10/2023 13:38

Could you ask the nurses for her and then relay it back to her in a softer kinder way?

cariadlet · 27/10/2023 13:39

We read "With the end in mind," by Kathryn Mannix for my book club last year.

I think you would find it helpful.

wordler · 27/10/2023 13:39

As well as the pain medication they often offer medication to deal with anxiety and help keep the patient calm. Some of the pain drugs can cause a kind of jitteryness or restlessness so they have medication to counter that.

My Mum died at home and the experience was similar to PP - was very quiet and peaceful - my Dad and I were holding her and talking to her through the end.

Angrymum22 · 27/10/2023 13:41

My mum died of secondary bowel cancer that had spread to her liver and lungs. It’s difficult to really advise because cancer, by nature is extremely disorganised and once it spreads and is not treatable either curatively or palliatively, it’s difficult to predict the progress.
Firstly, yes it will be painful, but this is where the palliative/end of life team come in. It doesn’t signify that the end is nigh but early pain control will allow your MIL to live a fairly normal life during the weeks/months she has left.
As time goes on continual review of the pain will allow it to be controlled. I think you will need to reassure her that painkillers will not signal the end but will allow her to live normally for as long as she can.
Secondly, fatigue is another major symptom. She may find just climbing the stairs becomes impossible. Sometime things progress rapidly and organising specialist beds and equipment can’t keep up. Maybe organise a wheelchair ( small portable) that you can store without her knowledge so it’s available immediately for if/when she needs it. I think this is where Macmillan come in.
Finally, I remember your first post and it sounds like your MIL is starting to process her diagnosis. It’s positive that she is asking questions but be prepared for some difficult ones. Be proactive, quietly, in the background and although you may already know the answer, tell her you’ll research and get back to her.
It’s great that she has a wonderful DIL even if you don’t always feel appreciated stuck with it. Supporting someone who is going through this is hard but ultimately death is just the end of life and being there does not have to be traumatic. We support our loved ones into the world, we should do the same as they leave.

tiredwardsister · 27/10/2023 13:50

Has she been referred to the palliative care team/Macmillan nurses? Where does she want to die if possible in my extensive experience home is the best place providing there is the necessary help from the above.
if she has benn referred why don’t you speak to them and ascertain what’s available and what help they can provide and how they will manage her pain. Most palliative care patients bring managed at home will be offered syringe driver off pain killers, treatment for breathlessness/anxiety/reduce production of recreations this will be reviewed as needed and the dose increased reduced as felt beneficial to the patient. They are also given to keep on their homes what many call “just in case” medications so if they get pain/or become anxious/breathless or produce to many secretions these can be given if and when required, if she is on a syringe driver they can still be given and the dose of f the medication in the syringe driver may then be increased when it is next changed. There is no evidence that giving patients with only days left to live food and drink prolongs their life it is fine to give to them if they want but forcing it down their throats will only cause distress.
You will hopefully be given a number you can call 24/7 when you MIL is nearing the end of her life. How much support you get from the palliative care team depends on your location, and how busy they are but IME staff involved and in palliative care will go above and beyond to help but if you live completely in the back of the beyond you’re likely to wait longer for a nurse to come out and say give an extra dose of a pain killer especially at weekends/nights.
The key is good communication with the team supporters you, pain nausea etc is much easier to get on top of if you call the staff sooner rather than later.

tiredwardsister · 27/10/2023 13:53

I just want to admixture that most people slip away peacefully especially if in a hospice/home.

Prettypaisleyslippers · 27/10/2023 13:58

I can recommend looking at a few hospice websites, Google stages of death, read hospice results or Macmillan.

MrsFrisbyMouse · 27/10/2023 14:10

The Kathryn Mannix book (both a physical book and audio) With the end in mind - is a great read.

She also did an interview this week on Woman's Hour on Radio 4 - might be worth tracking down on BBC sounds

And yes to her Ted talk - though it does make me cry as she is just so compassionate.

ColleenDonaghy · 27/10/2023 14:11

Just want to say what a lovely DIL you must be that she feels she can raise these fears with her. I hope you all get support for the time that's ahead.

Whatwillnye · 27/10/2023 14:13

It can be a different experience depending on whether she would like a medicalised/supported death or whether she would like to opt for natural death.
Death can be as absolutely beautiful as birth for some. It's brilliant she's able to confide in you but make sure you also receive support from people you can off load onto as this will impact you too.

lking12 · 27/10/2023 14:17

Is she under any palliative care? They will manage any pain. With the end in mind book talks a lot about basically becoming more sleepy, less active and not being able to be roused from sleep easily.
Hope you’re able to comfort her.

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