Care home & Stage 4 Cancer

[SuburbanKel]

First time posting here ..
Musings really and just wondering if anyone has any experience to share.

Lovely MIL - 85 yesterday was diagnosed with Stage 4 cancer in her Jaw last July after simply having a bit of toothache. Mega operation in September, where bone was removed from leg to replace jawbone, half teeth removed etc. Had to learn to talk again etc. Plan for radiotherapy to start in Nov was kyboshed when a scan the week before revealed the cancer was spreading and there was nothing to be done.

She got on perfectly fine at home within reason until just after Christmas when her left arm lost stregnth. It has spread to her brain causing this. Again, no pain, fully compos mentis etc. 3 weeks ago her left leg 'went' and she said she admitted she couldnt manage at home. She went to hospital to be assessed and has now been in a local care home for the past 10 days.

She has a lot of visitors and the care she is receiving is 'fine' but she is essentially bedrotting now and I just think the decline is going to be quicker and quicker.

Again, she's not in any pain or receiving any medical care as such - is this normal?
I believe the plan is just to go into the hospice for when deemed 'end of life' - it just feels so odd not having a clue what to expect. She could be like this for months I guess - or she won't be!

She looked so sad yesterday on her Birthday.. it's all just so sad I guess...

This is normal, the same for my nan at 88. It sounds like the cancer is widespread. My nan didn’t have any pain, either. It was a few months and she was compos to the end. That’s kind of what you want though, for your loved one to have a peaceful and painfree last chapter.

It’s difficult to comprehend though because we’re used to NHS responses being sleeves-rolled-up, get-the-big-guns out type deployment. With the very elderly, doctors and families consider the risks and benefits of treatment. What does your MIL want?

It may well be that she stays in the nursing home for end of life care. If you have good support from palliative care team and GP surgery and good nurses in the home no reason why she can't. They will get "just in case medicines ordered " so they are there for pain and agitation if needed.

Similar for my FIL for stage 4 cancer. Sounds perfectly normal. Unfortunately, sometimes we do have to let people die. There was no move to a hospice for us, there were no beds anyway so I wouldn’t pin your hopes on that. He passed away in the care home quite comfortably but there were weeks of limbo in between where we all knew what was happening. The care home will have been through it all before.

Many care homes are trained in hospice care because it’s often kinder not to move people. In patient beds at hospices tend to be used to get pain under control rather than end of life these days as they have outreach workers going into patients homes and care homes

Slightly different circumstances, my DM is 75 and in a nursing home, she will receive no treatment for any condition she gets, it’s called a ceiling of care. She will receive her end of life care at the nursing home, all the medications are in place for when she needs them.

I found the hardest thing for my own DM, in similar circumstances, was nobody was able to tell us when she might die (I think I was wanting a day or time or something!), and therefore when we could expect any hospice support, but as she also had an underlying condition once the meds for that were withdrawn she went on end of life care within days and she passed away quite comfortably within a week; she didn't have time to go to a hospice but was well looked after in the hospital.

I’m so sorry that you and your DMIL are going through this.

Could you talk to the staff in charge in the care home and see if they are able to provide end of life care? Like PPs have said, many Care Homes do this now and it would save her the need to he moved again.