Will you die sometime soon? How do you want to be treated?

[OneMoreFarang]

I have a 80 year old relative "back home" who will probably die because of cancer within a year or so. At least that is what the doctors told her.

With Covid it will be some time before I might a able to visit her. Now we talk on the phone every couple of days.

Obviously I ask her about her health, like "how are you feeling today". But until now I avoid talking about dying.

I don't know if I should pretend she will live many years more, which is possible but not likely. Or would it make sense to talk more direct about death.

We are not religious so that is no issue.

 

I ask and with the subject "will you die" because it would be good to read from people who are in that situation. I am sure it looks different from that side for a person who knows he or she has only months to live. How do you want to be treated?

 

[stouricks]

I personally would want the truth as it is, no fannying around. That gives time and opportunity to get things in order, say goodbye to friends & family, and decide which brand of single malt I am going out with.

[ezzra]

I was in such situation with a very dear friend of mine who since passed from similar ailments we use to to chat and reminisce of the good ol' time we had and i always found a moment to say that i have read somewhere that new discoveries in medicines and treatments are coming up all the time now and where there's is a hope, there's life, and i felt that in a way i did helped to make my friend feel somewhat hopeful... 

[Rimmer]

Troll post removed

[CharlieH]

If she is a good friend then it makes perfect sense to talk about the inevitable. This of course is dependent on whether she knows that is in fact the case. If she does know that her time is "limited" then I would open that conversation as she may well want to talk about it but may feel uncomfortable for you in doing so.

I would open that dialogue and let her lead it, she will either shut it down " dont want to talk about it" or you may have just given her the ability to talk and open her true feeling and may be fears etc.

 

Just a suggestion.

[Sheryl]

Take your cue from her.  You can create some conversational openings but don't push it if she does nto avail of them.

 

People vary greatly in how ready they are to discuss their impending death and even the same person will vary over time.

 

Also, people who fully accept and are dealing with their death, do not  necessarily want to focus on it or talk about it all the time.

 

Let her set the conversational agenda.

 

I would disagree with trying to offer false hope. It is usually done to help the speaker not the patient and creates a burden. Just leave it be and see what she wants to discuss. If she raises her death don:t contradict or tell her to hope, but if she instead talks about other things then do that. ANd if she talks about hoping for a cure, don't contradict that either. Neither encourage nor contradict.

 

The art of talking to dying people is the art of knowing how to listen and follow cues.

[1FinickyOne]

5 minutes ago, Sheryl said:

Let her set the conversational agenda.

This is a very tough question and is not going to have a flat out definitive answer, even for the same person... it could be a matter of mood too... so, as Sheryl says, let her lead and don't change the subject... 

 

I did once and regret it to this day... 

[thaibeachlovers]

She's 80. She knows she's going to die, unless she's senile. Perhaps she doesn't mention it because she thinks you would be upset.

You don't have to say anything about it if she doesn't bring up the subject.

When I had cancer and thought I'd die I didn't talk about it with other people because it's just not that big a deal when faced with the inevitable. I preferred to talk about positive things.

[thaibeachlovers]

19 minutes ago, Sheryl said:

I would disagree with trying to offer false hope. It is usually done to help the speaker not the patient and creates a burden.

ABSOLUTELY. People offering false hope are NOT, IMO trying to help the dying and are being selfish.

I made a terrible mistake once when nursing and promised a patient's daughter that her mother would be OK after an operation. The patient almost died that night of a reaction to morphine. The next day she was fine, but I never ever again told anyone that they'd be OK.

 

[thaibeachlovers]

2 hours ago, stouricks said:

I personally would want the truth as it is, no fannying around. That gives time and opportunity to get things in order, say goodbye to friends & family, and decide which brand of single malt I am going out with.

The Drs already told her that she's dying. It's up to her as whether to bring it up or not.

[OneMoreFarang]

7 minutes ago, thaibeachlovers said:

She's 80. She knows she's going to die, unless she's senile. Perhaps she doesn't mention it because she thinks you would be upset.

Lots of people in our family lived over 90 years.

She knows she is dying because a few months ago she had a check-up in the hospital and that was the moment when they diagnosed terminal cancer. The doctor told her at that time that maybe she has another year. He also told her she would be dead already if she would not have visited the doctor at that time.

 

Last time I spoke with her she told me she has currently a visitor from the palliative care. That was one of those moments were I could have said something like: I hope he helps you handling that you will die soon - hopefully in better words.

Instead I told her: I knew a guy who the doctors gave up already. They predicted he would die within 6 months. And then he lived for more than 10 years more. A true story.

 

It's difficult, and this is why I asked and listen to the different opinions here.

[wombat]

having had to face my mortality twice from cancer, believe me,
when i die i'm someone else's problem.

Edited May 18, 2020 by wombat

[phantomfiddler]

I,m not looking that poorly, am I ? ????

[wombat]

41 minutes ago, thaibeachlovers said:

a reaction to morphine.

yeah, it causes fluid in the lungs and you die drowning.

[thaibeachlovers]

2 minutes ago, wombat said:

yeah, it causes fluid in the lungs and you die drowning.

I think you are confused. Morphine can cause a number of side effects. A quick check on google did not find drowning to be one.

In the patient referenced she stopped breathing and required a reversal drug through the night to keep breathing. Luckily she did not require resuscitation or the ICU, as it would have been hard to explain that to her daughter that I had promised she would be OK. I doubt the patient herself knew anything untoward had happened.

Anyway, I only told that story as a reason why truth is always preferable to untruths, no matter how well intentioned.

[thaibeachlovers]

48 minutes ago, OneMoreFarang said:

Lots of people in our family lived over 90 years.

She knows she is dying because a few months ago she had a check-up in the hospital and that was the moment when they diagnosed terminal cancer. The doctor told her at that time that maybe she has another year. He also told her she would be dead already if she would not have visited the doctor at that time.

 

Last time I spoke with her she told me she has currently a visitor from the palliative care. That was one of those moments were I could have said something like: I hope he helps you handling that you will die soon - hopefully in better words.

Instead I told her: I knew a guy who the doctors gave up already. They predicted he would die within 6 months. And then he lived for more than 10 years more. A true story.

 

It's difficult, and this is why I asked and listen to the different opinions here.

IMO you are overthinking this. If she knows, and you say she does, it's her decision to talk about it, or not.

[OneMoreFarang]

8 minutes ago, thaibeachlovers said:

IMO you are overthinking this. If she knows, and you say she does, it's her decision to talk about it, or not.

Correct.

 

But is she says something like: "I am dying" then it's my decision if I say: "Yes, correct" or if I say something like "not yet, you might have years".

 

[Sheryl]

1 minute ago, OneMoreFarang said:

Correct.

 

But is she says something like: "I am dying" then it's my decision if I say: "Yes, correct" or if I say something like "not yet, you might have years".

 

 

Why on earth would you say either of those things? Especially the second which is apparently untrue?

 

Just say "I know. Is there anything I can do to help?".  Or if you prefer, simply "Yes, I know". In an empathetic tone of voice.

 

 

[Kerryd]

How would "I" want to be treated ?

If I had a terminal diagnosis, I'd want to get my affairs in order as soon as possible and then make "arrangements" to pass on while I was still of sound mind and body.

My dad died (in Thailand) 10 years ago (from cancer). He moved over here 2 years before that, knowing he basically had, at best, 2 years to go at best according to the doctors, and that was if he was in a hospital. So he beat their expectations (in that he made it two years but wasn't in a hospital).

He basically had most of his affairs in order and was living out his days somewhere warm, with someone around to look after him. However, the last few months were not pleasant (for him especially - the cancer really did a number on him).
During his last couple of months he was basically bed-ridden and towards the end he started to become incoherent and unaware of his surroundings. It was heartbreaking to see him like that, especially knowing he'd spent almost his entire life avoiding anything that resembled "charity" or being in a position where he had to depend on other people for help.

Even in the last few days, I had a hard time accepting that he was really that sick. I kept expecting him to make a recovery and return to normal (as normal as could be at 77 at least). Wouldn't have mattered if he'd been back in Canada, he was too far gone by the time he found out which is why he decided to move to Thailand. There was virtually no chance he could have beaten it, especially not considering his other issues (like a liver almost destroyed by a lifetime of heavy drinking).

I think if he'd had the opportunity to go out sooner, while he was still aware and coherent, he may have taken that route. Especially if he'd known what it was going to be like towards the end.
But that's in hindsight of course and by the time you get to that point, you may not have the opportunity (or faculties) to do it.

I hope I do have the chance to make that choice. I really don't want to take the long, slow (painful) way. I've seen what that looks like and it isn't pleasant for anyone.

Hopefully I won't have to make that choice for another 40+ years though. I keep expecting to win the lottery any day now and I've got plans !!
 

[kiteman9]

My family asked me if I wanted to be burnt or buried and I told them I would like them to surprise me.

[allanos]

Spike Milligan was humorous, even post-mortem.  The epitaph on his headstone (at St Thomas', Winchelsea), reads, “I told you I was ill”!

[OneeyedJohn]

44 minutes ago, thaibeachlovers said:

The doctor told her at that time that maybe she has another year. He also told her she would be dead already if she would not have visited the doctor at that time.

So at that time she was given another year, but also at the same time the doctor says if she hadn't visited at that time she would be dead already.

 

Just doesn't make sense, she visits the doctor and he says you would be dead already if you had not visited today.

 

Hindsight is just great, huh

[Lacessit]

I would agree with other posters that the OP raising the topic himself would not be wise. If she does, limit the response to sympathetic noises. How can I help is a starting point.

I have thought I would die several times, and I realized most people die alone anyway. That's the way it is.

[OneMoreFarang]

51 minutes ago, OneeyedJohn said:

So at that time she was given another year, but also at the same time the doctor says if she hadn't visited at that time she would be dead already.

 

Just doesn't make sense, she visits the doctor and he says you would be dead already if you had not visited today.

 

Hindsight is just great, huh

She visited the doctor for another reason - a check-up before a planned operation.

And during that check-up he found our how very ill she was. If she would not have visited him because of that check-up then likely she would have died already.

[OneMoreFarang]

1 hour ago, Sheryl said:

 

Why on earth would you say either of those things? Especially the second which is apparently untrue?

 

Just say "I know. Is there anything I can do to help?".  Or if you prefer, simply "Yes, I know". In an empathetic tone of voice.

 

 

Dear Sheryl

 

I guess you know that men in general like to offer solutions. I.e. if they see a woman with a car which does not work they want to fix that car. They don't go over to her and say: Oh, I am sorry that your car does not work.

I don't know how much I fit that stereotype but for sure I am better at "fixing" something compared to saying "Yes, I know".

"Yes, I know" feels like "Yes, that the way it is and we can't do anything about it." Which might be true, but it's (at least for me) unusual to admit there is nothing that can be done.

 

I don't know how much can be done for her. In the moment she is at home in her house and garden and tries to live healthy. 

 

Your comments help. Thank you.

[George Aylesham]

The question is 'How do you want to be treated?' One answer is write a living will' - easy enough to find a model on the internet and the law in Thailand is fairly compatible with British law. I got mine translated by a Thai lawyer to make sure it was locally legal and left a copy with my primary care doctor. This is for two reasons i) - I don't want to be kept alive artificially at great cost to my family and ii) makes it simpler for the doctor to provide strong painkillers if necessary.

[Aussieroaming]

My dad, lives in the uk and is 83. He has had cancer twice in the last 3 years (sinus cancer) and had the radiation treatment etc for it. He has also got dementia, which apparently has worsened due to being locked down and also has a serious heart issue and the doctors state he is "too old" for them to operate.

 

I wanted to go go see him because mum says he is on shaky ground but he is locked in with the Covid and I'm still stuck in a locked down country. He knows he could go at any time and has asked me to come over. I've said I will as soon as possible, but with this <deleted> going on its looking less likely that I will make it there. So I hopefully won't die soon but I have to accept that someone close to my heart more than likely will.

[connda]

6 hours ago, OneMoreFarang said:

But until now I avoid talking about dying.

I don't know if I should pretend she will live many years more, which is possible but not likely. Or would it make sense to talk more direct about death.

What you are reflecting is a pretty typical Western view of death. 
In my own opinion the entire concept of death is wrapped in fear and morbidity in the West to the point of absurdity. 

Here in a Buddhist country, it just is not that perceived that way.  In fact, in any Buddhist country or culture.  Forget that it's called a religion for a moment and just take it as a pragmatic view of life.  It's basis is "life is suffering" but there are methods to deal with it.
First off though you have to be willing to stare death in the face.
One of the core tenets of Buddhism is really simple:
You are born. You go through stages of aging - youth, middle age, old age.  At the end of that aging process is sickness and death.  You die. It's inevitable.  And it's the most natural thing in the universe.
But Westerners suffer immensely because they simply can not accept the obvious.  They don't want to explore it, they don't want to talk about it, they don't want to deal with it, they try to deny it - and it still happens but with so much anxiety, fear, and denial attached to the process that is literally destroys all possibility that there can also be joy and happiness. 

But go out into any Thai village and it just ain't that way.  Death is a process and it's as natural as being born.  There just isn't the stigma around death and dying that is attached to the process as in the West.  Villages die all the time.  It's a fully public affair.  People talk about it. People plan for it. And its not wrapped up in morbidity and shunned as in the West.  And funerals are public gatherings as are the public cremations - a celebration and a send off of a life hopefully well-lived.

So, what can you do?  Look at death like a Thai Buddhist. 
Birth, aging, sickness, death.  It's gonna happen. There ain't no getting around it.  So get in there and accept it.  Talk about it with your relative.  Get their feelings.  Share the universality of the process.  Instead on dwelling on the morbidity, try exploring the positives of the process.  Or you can ignore it like it doesn't exist and it isn't going to happen - and then suffer accordingly.

Listen to the attached talk on death by Ajahn Thanissaro who is a monk in California.  Toss the concept of 'Buddha' out the window for 20 minutes, forget it's a 'religion', and just listen to the subject regarding preparing for the eventuality of death and the death process.  If you find wisdom in that discussion, then you'll have a starting place to begin dialogue with those you know who are dying.  Plus, you'll start to understand why Thais simply don't view death in the same morbid fashion as Westerners.  What do you have to lose?
https://youtu.be/vKOLwxE8pu0

 

Just my two cents.  I hope you and your loved one can find peace instead of fear.


 

 

[OneMoreFarang]

18 minutes ago, connda said:

What you are reflecting is a pretty typical Western view of death. 
In my own opinion the entire concept of death is wrapped in fear and morbidity in the West to the point of absurdity. 

Here in a Buddhist country, it just is not that perceived that way.  In fact, in any Buddhist country or culture.  Forget that it's called a religion for a moment and just take it as a pragmatic view of life.  It's basis is "life is suffering" but there are methods to deal with it.
First off though you have to be willing to stare death in the face.
One of the core tenets of Buddhism is really simple:
You are born. You go through stages of aging - youth, middle age, old age.  At the end of that aging process is sickness and death.  You die. It's inevitable.  And it's the most natural thing in the universe.
But Westerners suffer immensely because they simply can not accept the obvious.  They don't want to explore it, they don't want to talk about it, they don't want to deal with it, they try to deny it - and it still happens but with so much anxiety, fear, and denial attached to the process that is literally destroys all possibility that there can also be joy and happiness. 

But go out into any Thai village and it just ain't that way.  Death is a process and it's as natural as being born.  There just isn't the stigma around death and dying that is attached to the process as in the West.  Villages die all the time.  It's a fully public affair.  People talk about it. People plan for it. And its not wrapped up in morbidity and shunned as in the West.  And funerals are public gatherings as are the public cremations - a celebration and a send off of a life hopefully well-lived.

So, what can you do?  Look at death like a Thai Buddhist. 
Birth, aging, sickness, death.  It's gonna happen. There ain't no getting around it.  So get in there and accept it.  Talk about it with your relative.  Get their feelings.  Share the universality of the process.  Instead on dwelling on the morbidity, try exploring the positives of the process.  Or you can ignore it like it doesn't exist and it isn't going to happen - and then suffer accordingly.

Listen to the attached talk on death by Ajahn Thanissaro who is a monk in California.  Toss the concept of 'Buddha' out the window for 20 minutes, forget it's a 'religion', and just listen to the subject regarding preparing for the eventuality of death and the death process.  If you find wisdom in that discussion, then you'll have a starting place to begin dialogue with those you know who are dying.  Plus, you'll start to understand why Thais simply don't view death in the same morbid fashion as Westerners.  What do you have to lose?
https://youtu.be/vKOLwxE8pu0

 

Just my two cents.  I hope you and your loved one can find peace instead of fear.

Thanks, I will watch it.

And in principle I understand what you are saying and I think I accept it - but I am only "middle age". 

If my relative accepts it is a very different question. She is the one who dies.

 

Maybe I should have mentioned this earlier: My question is not how I should handle my situation of accepting that she is dying. My question is about how to help her in that situation. If I would know she wants only hope then I would try to make her hopeful. And if she want to talk about having only limited time left then let's talk about that.

 

I think reading all the comments made me realize I should just ask her: "Do you want to talk about it?" And I should tell her it's up to her and I am ready to listen one or the other way. I guess she will tell me. And maybe she will change her mind from time to time. I guess it's important that she knows I am listening.

 

Thanks for all your comments.

[KhunFred]

If I'm dead, how will I know and why would I care? I actually had a Thai woman tell me that the soul stays conscious for a while after death and would feel pain if one donated their body to science. The level of ignorance is roughly equivalent to Protestantism in the southern United States.