My 79-year-old mother has Stage IV kidney cancer that has spread to her lungs, breast, and liver. She has tried, unsuccessfully, five different chemo treatments during the last 14 months. The side effects of the last chemo drug were severe, including nosebleeds, abdominal pain and swelling, and loss of bladder control. She is so desparate to continue treatments that she did not inform her doctor or me of the severe side effects until 5 days after they started. She will not listen to family members but is willing to believe anyone who offers her a "miracle cure." I am concerned that her doctors will keep trying treatments as long as she keeps asking for them (and Medicare is willing to pay for them). I no longer think that she is capable of making informed decisions about her medical care. I think its time to stop treatments and call hospice. My father has her health care POA but wants to follow her wishes. Is there anything I could/should do?

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My heart is with you.
First, I would speak privately with her oncologist and get their honest prognosis, and set up an appointment there with your mother and father and you just for a conversation. Everyone can ask questions and explore the different possibilities and eventualities. I would set up an appointment for the same day with a representative of hospice to come to her house for a similar question and answer session.
She may then be able to see that the end is near no matter what, and while she has little or no control over that, she has complete control over her quaity of life for her remaining days.
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Thanks for your response. Unfortunately, my mother has always had difficulty dealing with reality. She is in complete denial about the cancer being terminal. She has convinced herself that she is not going to die as long as the doctors keep giving her chemo treatments. None of the treatments has worked, and the kidney cancer has continued to spread. She withholds information about side effects from the doctor so she can stay on the chemo treatments. I'm concerned that the doctor has no idea what's really happening and she will die from complications from the chemo rather than the cancer.

My biggest concern is that she has spent the last 14 months trying to stay alive and has stopped living. She missed all of my son's school events and performances last year because she says that she can't be around crowds, but she still manages to make her weekly trip to Wal-Mart. She stopped going to church and cut off contact with most of her friends and relatives. She refused help from outside sources, and relies on my 80-year-old father to provide 24/7 care. I am worried about the continuing stress on him, and I am afraid that he will die before she does. She has stated, more than once, that she hopes that they die together.

My biggest fear is that she will have many regrets at the end of her life because of all of the things she chose not to do. She has been relatively pain-free during the last 14 months and she could have done so many things with her family and friends. I feel completely helpless at this point. Should I just say nothing and let her continue to believe that she's going to live forever?
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What a difficult one! Hugs to you.

Sometimes people want to stop all treatment and their loved ones have a very difficult time going along with that decision. My outlook is that if the person is mentally with in now or if that decision is consistent with what they've expressed all their lives, then hard as it is the family should respect the person's own decision.

We don't hear as often about the reverse -- when the person wants every treatment possible and the family thinks it is time to stop. But again I think I'd try to respect the person's own wishes, until the medical professionals say there is nothing else to try.

She may not be capable of making informed decisions, but is what she is asking for consistent with views she has expressed all her life?

Again, hugs to you. This has got to be extremely hard.
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