What To Do When A Par­ent Is Ter­mi­nal

GOOGLE “HOW TO HELP TER­MI­NALLY ILL PAR­ENT,” AND YOU’LL FIND LOADS OF USE­FUL CHECKLISTS THAT CAN FOOL YOU INTO THINK­ING YOU’LL BE PRE­PARED. BUT DO YOU KNOW WHAT IS AC­TU­ALLY WORTH­LESS? HERE ARE FOUR LIFE LESSONS FROM RON GERACI THAT COULD MAKE A DIF­FER­ENCE.

Men's Health (Singapore) - - GUY WISDOM -

SEE A PAL­LIA­TIVE CARE DOC­TOR RIGHT AF­TER DI­AG­NO­SIS.

This might seem like cock­ing a ri­fle around a limp­ing pony, but it’s es­sen­tial. Re­search shows that your par­ent will live bet­ter and pos­si­bly longer if you bring in a pal­lia­tive care spe­cial­ist as soon as you can, says Jen­nifer Temel, M.D., an on­col­o­gist and pro­fes­sor of medicine at Har­vard Med­i­cal School. Dr. Temel’s land­mark 2010 study in the New Eng­land Jour­nal of Medicine dis­cov­ered that pa­tients with stage IV lung can­cer who re­ceived pal­lia­tive care within two months of di­ag­no­sis lived longer than those who didn’t.

They also had sig­nif­i­cantly bet­ter mood and qual­ity of l ife. This was prob­a­bly due to bet­ter pain and symp­tom man­age­ment, less dis­tress, and less ag­gres­sive treat­ment.

MAKE A VIDEO

Mom wrote let­ters to us in case she didn’t sur­vive her first brain surgery. Had I been smarter and more pre­pared, I would have recorded a video af­ter she was di­ag­nosed and asked her to an­swer these three ques­tions:

1 What mat­ters the most to you at this time in your life?

2 What ac­tiv­i­ties do you most en­joy do­ing?

3 What do you re­ally hope to do in the next few months or years?

A video like this will tell the med­i­cal team what your par­ent re­ally wants from treat­ment, says Arthur Caplan, Ph.D., head of med­i­cal ethics at New York Uni­ver­sity School of Medicine. Hear­ing how your par­ent wishes to live and what he or she is liv­ing for--in your par­ent’s words--can of­fer an en­try point to talk about the ther­apy’s like­li­hood of de­liv­er­ing those wishes. Dr. Periyakoil cre­ated a let­ter tem­plate for do­ing this. (Google “Periyakoil” and “let­ter.”) Caplan rec­om­mends record­ing a video of your par­ent read­ing the let­ter to give it more im­pact to doc­tors.

FRAME DIF­FI­CULT QUES­TIONS WITH “WOULD YOU BE SUR­PRISED. . .?”

In­stead of ask­ing, “What’s the chance that Dad will make it to Christ­mas?” ask, “Would you be sur­prised if Dad died be­fore Christ­mas?” This word­ing may yield more hon­est in­for­ma­tion about your par­ent’s prog­no­sis.

RECAP WITH THE “TEACH BACK” METHOD

Physi­cians tend to de­liver bad news in a mas­sive info dump, buried un­der med­i­cal jar­gon and eu­phemisms. This helps ob­scure what might be emo­tion­ally dev­as­tat­ing. (For ex­am­ple, the word “le­sion” may sound less fright­en­ing than “tu­mour.”)

To get the true bot­tom line, tell the physi­cian how you’ll re­lay to an­other fam­ily mem­ber what he or she just ex­plained. Dis­till­ing 3,000 spo­ken words into “Dad’s can­cer has spread but you think chemo­ther­apy will buy him an­other three months of life pretty much as he’s liv­ing now” can help force specifics into the con­ver­sa­tion--or at least make the doc­tor aware if you don’t un­der­stand the sit­u­a­tion.

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