My MIL aged 86 has got terminal cancer and is steadily going downhill in a care home. Luckily with ovarian cancer there is almost never any pain.

The problem is that she is sweet old soul and not very bright at all. On top of that she is showing symptoms of delirium; the poisons from her infected and ulcerated legs are mixing with her blood and she is confused, not able to talk much and has lost her sense of time and doesn’t know what time or day it is or who has been to visit her. The stress for Mrs Gti is huge as she spends most of her time phoning, pestering, arranging, visiting, all to keep the right agencies involved and active in keeping her mum comfortable.

The GP is hopeless and as predicted by the specialist, has simply not shown any interest at all in the case. The first time he visited her he stood in front of her and said: “Why am I here? She’s going to die. Have you got her end of life plan sorted out?”

My MIL does not know she is dying and although she may have guessed it nobody has discussed it with her. She is depressed and feels unwell but doesn’t understand why. None of us has the courage to discuss this with her and Mrs Gti thinks ignorance is the best plan but… is it right to give hope to a sick person by continually telling them they will get better soon? Wouldn’t she be better off being told she’s dying so that she can get to grips with the idea? She doesn’t have religious beliefs and doesn’t really understand what is happening.

Anybody else been in this difficult position? What did you do?

Hi – so sorry to hear this – very difficult position – could a Macmillan nurse offer any advice? All the best

Similar with my mum (lung cancer) – I just stood by her and supported the best I could and spent as much time with her as possible.

No idea what you should do, but good luck and take care. I would add that I expect most 86 year olds kind of know they are dying at some point in the not too distant future.

No idea what you should or shouldn’t do, but my sympathies are with you and your wife. That’s not a nice situation to be in.

Get her told!

It’s a poor state of affairs when people are not involved in their own health/life/death decisions. She might not take the information in, but she might and to deny her the opportunity to know about it is wrong in my opinion.

Not quite the same, but my old man died last year. It had been on the cards for a long time but when the final diagnosis finally came it was brutal. What pains me most about his death is how he dealt with the last two weeks in his own mind – he was very stoic, didn’t talk about it at all and I think we all appease ourselves knowing / hoping that he was sufficiently drugged up and confused similar to how you describe above that the cold, harsh reality was dampened for him.

So, yes he knew and was ultimately told by professionals that this was it. The care home staff, or someone there, should be trained to deal with the situation. Otherwise, maybe try speaking to Macmillan or the likes – its their job but they do it right, unlike how it sounds your GP might handle it.

I’d say you need to tell her, even if she doesn’t totally take it in.
You might be surprised by her reaction – ie she’s probably worked it out already.

The day we told my younger brother he was going to die was one of the hardest days of my life – His consultant offered to deliver the news for us, which was a great help. Totally different situation as he was only 36, but we did feel a weight lift when it was done.

What will knowing achieve for her? At least when you have no idea you always have some hope that you will recover. As she’s in a care home, she has people looking after her and a family who care.
Do you want her to have the news that there is no hope and death will be soon or feel that she’ll get better? I know which I’d prefer.

crikey – Member
Get her told!

tbh I don’t really agree, if she isn’t aware enough to know her own state of health, knowing isn’t really going to do her much good.

Get some advice from the Macmillan helpline 0808 808 00 00 – they are happy to help families as well as those who are living with cancer.

Ultimately she needs to be told,and it’s best coming from the family, but you need to liaise with the nursing home as they will be able to help you with picking a time when she is most lucid.

Won’t be easy and I don’t envy you the task but call the helpline.

I do it as part of my job and done with care, it gives people the chance to make peace with the world and the people around them.

if she’s suffering from potential dementia etc, it may be best (eventually) to just tell her she’s very ill.

it was heartbreaking telling my great aunt that her husband had died. and then telling her again 2 days later. and then again 2 days after that.

Eventually we just started telling her he was away. 🙁

Morally very difficult. I feel she has the right to know, she’s not a child, but also having been there understand why a white lie might not be terrible. particularly if as you say she is a little confused and there’s no pain to explain.

My grandfather had untreatable lung cancer, but wasn’t told until it was very advanced and couldn’t be hidden. Turns out he ‘knew’ all along, but wasn’t admitting it because no-one else seemed to want to talk about it and he thought he was protecting them. Once in the open – he said his piece and deteriorated very rapidly thereafter, dying within a week which was a blessing to all.

+1 to speak to Macmillan, there’s nothing they haven’t seen before and at least will have someone trained to help with whatever route you take.

My sympathies to you and Mrs GTi

OP have a search on Google for SPIKES which is a six step protocol used by clinicians when discussing bad news with patients. It was developed by an oncologist. It’s meant for a professional setting so
is not all applicable to you, but the general principles are sound

Best of luck

What a difficult time for you alI. I was always optimistic with our grandfather. He was going downhill fast but we didn’t discuss it, I was more interested in keeping him occupied and hopeful, if only that tomorrow would bring sunshine, or fish and chips. Fish and chips I could do, and the sun shone as we shared them together on his bed-tray. I had nomway of knowing that it was the last moment we would spend together. On leaving I promised him a radio and a talk with a physio as he was getting stir-crazy. I was not told he had possibly days to live and I’m sure we would have discussed it.

Keeping spirits high and living in the moment/talking of the future were maybe my ways of dealing with imminent loss. I have never regretted that. Not knowing your MiL, mileage will vary re discussing mortality, they are of course entitled to know if it is known – but the love, time and attention are a given so be easy on yourselves, so your relaxed mood makes it easier for her when you visit.

OP, we are going through something similar at the moment. She knows she is dying and was scared and uneasy about being in hospital. She has since been moved back to the care home where she has been living for a couple of years. The staff and doctors have been great and have been as good with the family as they are with her.

It’s a tough time and my thoughts are with you and your family.

Thats a awful situation , all I can say is support your wife as much as possible , make home life as easy for her as you can . Definitely talk to the Mcmillan team they’re brilliant in my experience with them .

I’d tell her. If it was me I’d want to know.

I think there is a big difference between deliberately hiding or withholding information and not being asked so not saying. There is no place for the former but the latter might be what she wants. My father was a lot younger and mentally competent when he died and knew what was on the cards but didn’t want to know the specifics or to articulate it. He never asked the ‘how long have I got’ question but my mother went back without his knowledge to ask as she felt she had to prepare herself. I always wished we had had some final conversations but it’s just not how he wanted to handle it and we respected that.

Good luck, I hope she suffers little and your wife is well supported too.

on a practical point of view, if she has any savings things are much easier if they are all with the same provider.

Talk to Macmillan, they’re brilliant.

In the meantime, it’s probably best to take your lead from the lady herself. Some people actually feel comforted by the knowledge they’ll be “passing” soon. Others prefer to completely ignore things. No ethics, no moral dilemma, no right-or-wrong – simply a different approach.

Just continue to support Mrs Gti at this very stressful time.

It might be best if you are there with a specialist when telling her. My MIL knew she was dying and was in pain but the dr in hospital thought her statement “I want to go on” meant she wanted to live, rather than moving on to the next world. We had to translate.

As others have said sorry to hear of the situation and hope you get through it the best you can.

The only input i can offer is that when my grandad passed away he had been going down hill for a period which gave us chance to spend time with him even if he was in a hell of a state come the end. From, i guess, a selfish point of view i am very glad i had that chance. Not sure how much he was aware of but any flicker of response was worth it. So as an aside to your main question i would just say spend as much time as you can with her.

All the best.

Sorry to hear your news,

Yep, MacMillan again..

MacMillan were great with support for my mum in the last weeks my dad was alive, loads of compassion and they knew just what to do and say at the right times. Hugely helpful.

Normally I’d say she needed to know but if she’s lacking the mental capacity to process the information (I’m not in a position to say this is or isn’t the case but it sounds like it might be) then I don’t think there’s any benefit to your mother in law knowing about her condition. If she’s able to voice any specific concerns then deal with those but I’m not sure I think it’s a good idea to make her hear something that she might not be able to deal with.

As stated above Macmillan should be your best point of contact.

I told my dad, hardest thing ever, but it allowed us all to move on.

As for your circumstances, McMillan will help find a way forward for everyone. Hugs and support to Mrs GTi. Caring for your parents at the end of their life is so very hard. So spend time with her and away from us on STW.

She needs to be told. I am sure she has the mental faculty to understand that she will not get better and, sadly, her life will come to an end. It is cruel not to be honest and straightforward. Your wife and any children also need to adjust and not act as if there is nothing wrong when in her presence.

If she asks about her medical condition I’d tell her truthfully. But if not I wouldn’t mention anything. Just support and love her during the time she has left.

You have to tell her. Not doing so shows a complete lack of respect (unless she’s specifically asked not to be told in the past).

How would you feel in her shoes?

Do you have things you want to think/say/feel before you die?