Dying from cancer...

January 22, 2007 2:00 PM

My friend is dying of cancer. It's just a matter of time before she goes since she has stopped receiving treament. She is bedridden, can't see and is too weak to talk but she can still hear. What can I do for her on our visits to help her get through the day? Are there massage services out there (NYC)? Should I read her a book - what's a good title? Should I ask her family if they will allow me to play some CDs for her - any suggestions? Your input is greatly appreciated.
posted by anonymous to health & fitness (28 comments total)

Dunno if it's your place to be thinking about this, but make sure she has adequate pain control.
posted by NucleophilicAttack at 2:07 PM on January 22, 2007

If you wanted to read her a book, but weren't sure which one, you could try asking her family what her favorite book was when she was young. That might be a bit of comfort to her.
posted by Attackpanda at 2:14 PM on January 22, 2007

What can I do for her on our visits to help her get through the day?

One thing I'd highly recommend is to keep touching her (glad to see you thought of massage services) - I think one of the things we often forget (or even avoid) with the sick and dying is the need for human touch. It speaks volumes more than words or actions - CDs and books are great ideas, but don't forget to hold her hand, caress her hair, put a hand on her shoulder, etc.. Nothing speaks "I'm with you" more than that.
posted by allkindsoftime at 2:15 PM on January 22, 2007 [3 favorites has favorites]

A book sounds nice, but how would you know that she would want to hear it? Also, being a good narrator can be a difficult task. Certainly having someone caring by your bedside in your final days is very comforting and a great act of kindness on your part.
posted by parallax7d at 2:16 PM on January 22, 2007

Her favorite book on tape/cd. My sister liked young adult fantasy sci-fi while she was sick (she was 28 when she had cancer), but your friend might not be into that. If your friend likes this kind of thing I'd recommend Garth Nix's Abhorsen Trilogy. Compelling storylines, and an interesting take on the afterlife.
Mostly you should just be there and talk to her when she wants to, though. I'm sorry that your friend is dying. You will never egret any tie that you spend just holding her hand.
posted by Sara Anne at 2:17 PM on January 22, 2007

um, regret, not egret.
posted by Sara Anne at 2:18 PM on January 22, 2007

Second allkindsoftime thoughts about touch, worth combining with aromatherapy. Other complementary therapies to consider: raiki, reflexology, indian head massage, beauty treatments (esp manicure, pedicure) if that might be her kind of thing.

Talk about the things you'd normally talk about: reminisce, talk, laugh, tell jokes. Being there for her, even in silence, is still great.
posted by wassock at 2:34 PM on January 22, 2007

Tell her how much you love her. Hold her hand, and talk to her about the time you spent together, shared experiences, specific things you remember about those experiences. My heart goes out to you, your friend and her family.
posted by dbiedny at 2:41 PM on January 22, 2007

In terms of getting massages, you can call the Swedish Institute, which is a massage school in the city, and ask them to recommend a massage therapist who works with cancer patients. The main phone number is 212.924.5900. You can also use their web directory.
posted by blueskiesinside at 2:50 PM on January 22, 2007

This question I asked a couple of months ago might help you. I went throught the exact same thing not too long ago...

From my personal experience, the best thing is just be with her, really be with her. Even if you're not talking even if you don't find those moments very fulfilling, those are the only moments you're going to get anymore and take every single second of that time.
posted by liquorice at 2:51 PM on January 22, 2007

What about a favorite movie or TV show? You stated that she can't see, but she can still hear... Maybe you could put on one of her favorite movies and just sit with her and comment about it (she'll be able to visualize in her own mind what's happening on-screen if it's a movie she's seen and enjoyed before).
posted by amyms at 2:54 PM on January 22, 2007

Tell her about your day. Seriously, having something that is a little normal to hold on to means a lot. I found that out when my cousin and aunt had cancer. Touch is good too, it shows that you aren't scared to get close to her. A lot of my family stayed far away from my cousin: they wouldn't sit next to his hospital bed, didn't kiss him, didn't even touch his hand. They acted as if he was diseased.

I am sure that she is glad to have such a sweet friend like you.
posted by slc228 at 2:57 PM on January 22, 2007

Nothing speaks "I'm with you" more than that.

About the physical contact idea (although what I'm about to say can and should be applied to any other suggestion): If possible, try and find out about your friend's preferences. Personally, I hate being touched by just about everyone, especially when I'm unwell. Having someone - no matter how well intentioned - pawing at me when I'm terminally ill is my idea of hell.
posted by buxtonbluecat at 3:07 PM on January 22, 2007 [2 favorites has favorites]

Go on vacation! Of course the person can't leave the bed but you could describe all the neat things you would do, where you would stay, eat, and all the fun stuff you would partake inbetween... as if you were there.

My best friend kicked the can sometime back and it sucked beyond comprehension; just before the final slide we went to the beach, if only in his mind's eye, but we had a fun time. The next night he cashed in chips and, I have to imagine, probably went to the beach.
posted by bkeene12 at 3:10 PM on January 22, 2007 [1 favorite has favorites]

When I took care of my mom in Hospice I often made sure my husband was there, or someone else was in the room with me, so we could have a little conversation. Just small talk, like how your day went or how the weather is. I figured mom would enjoy hearing people talk. (She was unconscious at the time, we don't know if she could hear but we assumed she could.)

Remember things she liked to do. Is there a favorite tv show she watched? Keep her up to date on it. Did she plant flowers or have plants inside? Tell her how they're doing. Try to keep the topics light. If you feel like you're going to cry, go ahead, but do it outside the room if you can.

The music is a good idea. You can always rub lotion into her hands, give her a manicure or pedicure, comb her hair (if she has any, my mom didn't have much at the time because of chemo), etc. Just be with her, even if you're not talking. Hold her hand and tell her you're there.
posted by smashingstars at 4:10 PM on January 22, 2007

About the physical contact idea (although what I'm about to say can and should be applied to any other suggestion): If possible, try and find out about your friend's preferences. Personally, I hate being touched by just about everyone, especially when I'm unwell. Having someone - no matter how well intentioned - pawing at me when I'm terminally ill is my idea of hell.

Not altogether a bad suggestion - you will of course have to use some personal experience here - if you weren't close enough friends to share touch in the healthy times, proceed with caution. Her family can probably help you gauge this too.

That said, I think (generally), when we are on our way out - we are many times about as vulnerable and dependent on others as we were when we were on our way in. And there's studies that tell us what happens to babies suffering for lack of human touch...

Personally, I'd rather be holding someone's hand than clutching a starchy, stiff sheet...
posted by allkindsoftime at 4:57 PM on January 22, 2007

I'm all about getting DVDs of her favorite shows from long ago. If I had to guess, this is the time when I would mentally revisit everything I loved as a kid. Did she grow up watching Sesame Street or Electric Company or MASH, etc.? What about ridiculous movies she's always wanted to see? Same goes for kids' movies. YouTube works wonders by the way.

I also LOOOOVE the idea of a vacation in one's mind, as suggested by Bkeene12.

And, I agree that your somewhat constant presence will help her beyond all else.
posted by santojulieta at 4:58 PM on January 22, 2007

Seconding all the people who said simple affectionate touching (hand holding, hair-stroking) and the usual small-talk about the day-to-day is good. If you know her well enough that you can have a believable imaginary conversation in your head with her, then you can speak both parts in a conversation with her: "blah blah blah...you'd probably say blah blah...well blah blah..."
If she has favorite movies or TV shows, you could put them on a DVD/CDR and watch them with her on a laptop or portable DVD player. If you want to read to her but have no idea...well, I'd suggest something by Judy Blume or some other young-adult fiction-classics. It's hard to recommend books or CDs without knowing about what she likes...but virtually everyone likes Judy Blume. Ambiet 2 by Brian Eno & Harold Budd is, IMHO, the classic chill-out instrumental CD. Close to it is the Moon & the Melodies. Peter Gabriel's Passion and Passion Sources....all these are CDs that people I know (be they punks, metalheads, chart-pop-fans and classical or jazz-enthusiasts) have liked a lot, and they're relaxing and soothing but interesting to listen to even if you don't normally like quiet instrumental music.
But choosing the right book/music/TV/film is icing on the cake. You're doing a very good thing just being there for her, and 90% of it is just in the being there. It will mean a lot to her and her family. It can be very taxing so don't shy away from taking a break when you feel you need one.
posted by Martin E. at 5:24 PM on January 22, 2007

Having been through this twice, my only advice is just be there, touch, talk, read, play soothing music, anything you can think of to just let her know you are there. Just stay sensitive to when she is over-stimulated, and give her space when you sense it. Go with your heart. God bless you in this, you are doing a difficult but wonderful thing.
posted by The Deej at 5:49 PM on January 22, 2007

A person who is very, very ill, and possibly recieving heavy pain meds, as well as other medications such a xanax for anxiety control, may well be drifting in and out of conciousness, although they appear to be awake, if not entirely alert. At that stage, the mental clarity necessary to understand and follow even familiar program materials can be largely if not entirely lacking. Play something familiar, if you like, but keep the volume low, and recognize it's probably more of a comfort to you, as her friend, than to her. And that's all right, too, if it makes your visits easier.

What you can do, that has immediate benefit and comfort for the patient, is to apply skin lotions to their feet, hands, shoulders, elbows, calves, and arms. Hospital linens are very drying to the skin, and frequently changed, so it is quite likely your friend will appreciate greatly additional moisturizer, which helps to relieve and prevent itching. You can also pay attention to her lips and tongue, and make frequent efforts to apply glycerin sticks and mouth swabs, to prevent her lips from cracking. If she's unable to talk, she maybe restricted on oral fluids and even ice chips, to prevent choking or swallowing difficulties, but even patients in those conditions can usually have flavored glycerin swabs, which greatly ease a dry mouth and lips. Finally, you can wash her face with a clean warm cloth, and brush her hair. If it has been some weeks since she has had a shampoo, you might even speak with the nursing staff, and see if they have a basin or table you could use to help her wash her hair. Even if it washes out some color and what remaining styling she may retain, the pleasure of having a clean scalp can be immeasurable, to a person who has been confined to a hospital bed for some weeks, and it is not a service that most nursing staffs have time to do routinely, but are happy to assist friends or family members in providing.
posted by paulsc at 5:53 PM on January 22, 2007 [1 favorite has favorites]

When my brother was very ill (cancer also, and the ill-in-bed part lasted for many months before he died), he listened to many books on tape, sometimes the same book over and over.
posted by ClaudiaCenter at 6:37 PM on January 22, 2007

Sometimes families and friends do too much to keep their loved ones "in the world" at the very end. People need to detach from their loved ones, to mourn their own mortality at the very end. It's selfish in the literal sense of the world but it's very important and very common. Don't be surprised if, even though she's conscious, she isn't interested in following the plot of a new story or listening to challenging music.

You have to take your cues from her, not from anyone else. She might prefer readings from an old favourite story (and not something new that she would have to follow), or her favourite poetry, or whatever. She might enjoy quiet, familiar music, or she might find it annoys and frustrates her. Or she might just want someone to be with her, to calm her fears. If she's afraid of dying alone, just having someone there can be a real help, beyond any distractions you could bring.

I do have one negative suggestion: please stay as far away from aromatherapy as possible. People who have undergone chemo often find their sense of smell is altered, and may also have an increased chance of an allergic reaction. What smells soothing to you may smell like a skunk to her. Plus, does she (or, just as importantly, the person in the next room) really need an asthma attack on top of everything?
posted by watsondog at 4:05 AM on January 23, 2007

Does she want you there?
Don't flame me. I ask because she can't talk and you are considering asking her family (not her) if it's ok to play CDs.
Those of you who are saying "your constant presence will help her beyond all else" are doing some assumin'.
posted by Saucy Intruder at 4:46 AM on January 23, 2007

Sometimes families and friends do too much to keep their loved ones "in the world" at the very end. People need to detach from their loved ones, to mourn their own mortality at the very end. It's selfish in the literal sense of the world but it's very important and very common.

Personally, I don't consider this sound advice. You have all the time in the world following your loved oneds death to grieve for your loss that I see no reason to do so while she's still alive, even though it may not be in a form you are used to seeing her in. Concentrate on doing what you can for her and for the family and don't forget to look after yourself either.
posted by liquorice at 5:02 AM on January 23, 2007

I guess I think that you should take it easy with the 'input'.

By that I mean, as some have expressed, having things arranged the way you think they should be arranged - by reading or playing music or favourite shows etc etc - are to my mind doing more to ameliorate your understandably depressed state and less about being a friend at this time. Yeah, I guess a little modest background music is unlikely to be an aggravation but it won't really be doing much if at all on the comfort front.

I would go with the 'less is more' philosophy. Just being able to lie there pain free (it's hoped) without intrusions is probably going to be a bit of a high point in this declining period of her life.

Hold her hand, touch her from time to time but don't overdo that either. She's your friend. Talk to her (not continually and not necessarily when you think she's particulary 'with it' --- whether she actually is able to comprehend and follow is something you probably won't be able to judge) about your shared experiences and lives. Tell her what you've been doing and who you've seen. Let her know if you've been in contact with her family. I reckon a little input of a familiar voice is far more likely to be an aid to comfort than is muzak.

Spread this talk out and do it a little bit slower and a bit more subdued than normal (not hugely) and even pretend that she's on the telephone with laryngitis and your job is to keep the friendship going if it makes it easier. In my opinion (and I guess I've had a fair amount of experience with death), spending the time there and occasionally touching and talking are the most that you could probably hope to contribute (accepting all other things like nursing care/pain relief have been taken care of).

If the situation is that your friend is getting lax enough care that a massage therapist seems required, then she is obviously in need of a nurse. You can rub a bit of cream in as paulsc has suggested but again, don't do it to such an extent that it will interfere with those 'high points' she has of simply lying there comfortably. There is no magic. But she is lucky to have someone who cares.
posted by peacay at 8:39 AM on January 23, 2007

what peacay said. I'm a nurse and have been at many a terminally ill patient's bedside.
Just be there, with quiet and cheerful love.
posted by bkiddo at 10:57 AM on January 23, 2007

I'm late to the discussion here, but you might find some of the answers from the question I asked a few weeks ago to be useful too.
posted by vytae at 12:46 PM on January 26, 2007

Oh, and also... my condolences. Remember to take care of yourself as you take care of your friend and her family, too.
posted by vytae at 12:50 PM on January 26, 2007