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jerrye Asked November 2015

My Father (77) has prostrate, bone and spinal cancer. The doctor told us that he was not a candidate for chemotherapy. Now what?

He has received radiation on all cancer areas and hormonal shot therapy.   He had a five artery bypass heart surgery about fifteen years ago and three major strokes about ten years ago. I know he wants to come home but my mom is 76 yr old and will not be able to care for him. What should we do now.

EXPERT Carol Bradley Bursack, CDSGF Nov 2015
Jerrye, the message is hard but from what you said I believe the doctor is saying that it's time to focus on making the time left the best possible. That may mean going on hospice care if pain becomes an issue. Hospice isn't only for the last days or weeks. People who have a terminal disease that is likely to give them six months or less of life will qualify. It may be time to look at having fun with your dad and enjoying the time he has left. If he cannot care for himself at this time, then look into in-home care to come into the home for both of your parents.

There is a time for all of us when we need to re-focus our thoughts on how to live the life we have left rather than chase after another treatment that won't work but will make the person receiving it miserable. It sounds as if the doctor is wise enough to see this.

If your family has a spiritual background, now may be the time to call on the pastor or Rabbi for some help. It definitely sounds like a time for the family to focus on love and life which facing the reality that your father's life is limited.

I apologize if I'm misreading your question but if I understand it right, my advice is to focus on making the next months about your father's life and comfort.
Take care of yourself, too.
Carol

OldBob1936 Nov 2015
A merciful God hides the future in misty darkness. In this case, alas, it appears the future is now. From what I understand of what you are saying, your dad has stage IV cancer and doctors may well be saying it is just a matter of time.. Perhaps looking into hospice at some point a little more down the road may be appropriate . +1 on both comments previous to mine....The able people get the burdens. Bless you all.

Grace + Peace,
Bob

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Wilmav Nov 2015
Jerrye
Hearing that news is hard. You have options. I suggest you find a social services advisor. Hospice sounds appreciate at this time. Quality of life and pain management for your father;along with respite for you and your mom. Aging Life Care Professionals ( Geriatric Care Manager) maybe helpful as well.

freqflyer Nov 2015
Jerry, why would your Dad need care? What is it that he isn't able to do for himself now? That are some side effects to radiation, and with hormonal shot therapy the men will get hot flashes. But after the treatment one usually gets back to a normal routine.... same with the bypass surgeries.... or is the main issue the major strokes? Did your Dad have physical therapy with each one?

If your Dad isn't mobile enough to help with his own daily routine, then it is time to hire paid caregivers to come in to help, or time to place Dad in a continuing care facility under self-pay or Medicaid. Sad that he is going through all that, he is still pretty young by today's standards.

MaggieMarshall Nov 2015
Certainly the docs have a recommendation...?

As FF says, at-home care or self-pay or Medicaid nursing home care. The only question is whether palliative care or hospice is appropriate.

I am very sorry. It's hard...

JoAnn29 Nov 2015
Hospice requirements have changed. You no longer have to be diagnoised with six months to live. Talk to his doctor. There are Hospice homes and Hospice in the home.

Angelkw Nov 2015
Have you tried the Gerson method?
Angel

Veronica91 Nov 2015
I am not up to date on the current requirements for hospice care but in general the
patient should have a diagnosis that is likely to end their life in six months or less. There are set benefit periods and at the end of each the hospice team will review the patients condition and if they are no longer appropriate in terms of their illness they will be discharged, however their is no bar to readmission should the condition worsen. This is solely related to the illness not how much help is required for the patient in the home. Extra help such as aides or physical therapy has to be obtained through other sources as does any equipment hospice provided such as a bed or oxygen. This is only an inconvenience because these things will now be prescribed by the PCG and the company supplying them may be different but they will still be available.
As far as the original poster's father is concerned now as others have said is the time to enjoy whatever time he has left and no longer try and make him do things "that are good for him" decline any tests for which you would not be a candidate for treatment anyway. help the the patient achieve any goals they have such as visiting certain places and seeing loved ones and patching up old quarrels. The spiritual part is also very important so give the patient access to a spiritual advisor of his choice preferably one he is familiar with of his own faith. Medications are no longer very important, except to control pain and things like nausea, depression or anxiety. It is important to have enough support for the caregiving who is often also elderly and overwhelmed on many fronts.

JoAnn29 Nov 2015
Jeanne, my daughter is an RN in a Rehab/nursing facility in Delaware. She told me the criteria had changed. She has patients that were reevaluated and considered Hospice elligiable. Her explanation, they don't have to be dying just die from what is wrong with them. One patient had been with them five years with the same problem she was now OK'd for Hospice. Call a Hospice center or a home Hospice. Ask if they have info on the criteria.

bigtenmom2000 Nov 2015
I would recommend watching the PBS Frontline special, Being Mortal, or reading the book of the same name by Dr. Atul Gawande. It might provide some insight into the journey you are now on with your family. pbs./wgbh/pages/frontline/being-mortal/

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