My 80-year-old mother was diagnosed with incurable Stage 4 kidney cancer three years ago. She has never accepted the diagnosis and has tried all of the chemotherapy and radiation treatments available. She is no longer taking any cancer treatments and is on pain medication because the cancer has spread to her bones. Even though the doctors have tried to explain to her that there is nothing else they can do, she continues to believe that she is "going to get better." Both my father and my brother are encouraging her belief because they do not want her to give up hope. I think that it is time for hospice to be called to assist with end-of-life planning and to help my 81-year-old father who is her caregiver. I live out-of-state and will be visiting next week. I don't know whether I should "play along" and pretend that everything's going to be fine, or ask everyone to sit down and have an honest family discussion about what needs to be done. Any advice would be greatly appreciated.
It sounds as if your dad and brother know that your mom is terminal and that they're just keeping a stiff upper lip for your mom's sake so it's not like your entire family is in denial. Definitely broach the subject of hospice to your dad. His mind may snap shut because "hospice is for people who are dying" and the word "hospice" scares a lot of people but there will come a day when your mom's pain will need to be more closely monitored and hospice will do that. Get them on board before that day comes. It's much better to have hospice and not need it than to need hospice and not have it.
It's also possible that she knows the truth, and her assertion that she'll get better is for the sake of your father, your brother and you, to try and lift your spirits. Who knows what she really thinks? People can be a mystery, even to those closest to them.
Getting hospice on board wouldn't necessarily crush your mom's belief that she's going to get better, if that's what she thinks. They could help with her hands-on care and discuss end-of-life planning in private with your father. It's not as if they march in and announce to the patient that they're there because he or she is going to die soon.
Why not talk things over privately with your father and brother?
It sounds like your mother is of sound mind and, as been said, she my be taking this stand to protect the rest of the family from grief. In the end, there must always be hope.
I had a friend with kidney cancer who passed away but when we took him to Johns Hopkins for a second opinion, the specialist said it was a tricky cancer, as it can sort of start and stop. So I'd hold out hope but also work with your dad and brother to make sure all of the bases are covered as far as end of life care.
Does your mom want to be resuscitated if her heart stops? If not, get a Do Not Resuscitate order (DNR) in place. Would your mom want a feeding tube? Those are the really tough questions your family needs to decide on before you hit that point with no clear direction. Hugs to you, this isn't easy whatever you do.
At this point, I think it's a good idea to talk to my brother and see whether he thinks we should arrange for hospice care. He went through this with his father-in-law several years ago when he was diagnosed with terminal cancer. I am very concerned about my father's health since he seems to be overwhelmed by the demands of caring for my mother 24/7. They have refused offers of help from family and friends because they want to maintain their independence. However, my mother tells me that there is no food in the house because my father keeps "forgetting" to buy things when he goes to the grocery store on his own. I am concerned that we need to intervene soon to make sure that both of them receive the care that they need.