Tough Talks

As Mom gets stronger following her cancer surgery, and as the window of opportunity for starting radiation treatments closes, it’s time talk openly and honestly and to make tough decisions. What would the radiation do to her quality of life? How much would it help? Would she be buying only a little bit of time at the cost of great misery? What if Mom chooses not to have radiation? What is her prognosis? Will she be able to live at home again, or in assisted living, or will she have to spend the rest of her days in a nursing facility?

Even though Mom still seems confused at times about where she is, the depression/anxiety meds are keeping her level and calm. She will occasionally say something like, “Looks like I’m going to be here for a long time.” I probe, “What do you mean, Mom?” But she doesn’t continue the conversation, and I stop probing.

Next week Mom will have an appointment with a radiation oncologist to get the answers to these and other questions and to begin the process of radiation. This doctor will no doubt promote radiation as the appropriate course of treatment; that’s his job. But I want Mom to see that there’s another choice – the do nothing choice – and to understand the consequences for each choice.

I thought a more neutral doctor might be able to help, so I took Mom (with Dad tagging along) to see her primary care doctor. He more or less followed the script in my head: “You could choose radiation, but that’s not a cure…it’s only palliative. It may shrink any remaining cancer that’s there but won’t cure it. It may make you feel tired, but I’ve had no experience with that type of cancer and can’t tell you all the side effects. Or, you can choose to do nothing, in which case, I would probably recommend that you explore the benefits of working with a hospice organization, for which Medicare will cover the cost…”

Mom expressed some dismay over what the doctor said, to which he asked, “What did you want me to say?” Mom quickly replied, “No, I want you to tell me the truth.”

The doctor promised to visit her next week following her radiation oncology appointment to further explore her options and decisions. I like this doctor and believe he will be a comfort and help no matter what Mom chooses.

My job is to be ready to listen when Mom wants to talk; to help her find answers to questions; to help her get past her fear; to help her feel loved and cared for. I’m also one who prays (which is not to say others aren’t praying, too). I think about praying with her, as well as for her. But since we are not in the habit of praying together, I worry that she will think I’m trying to deliver some sort of final rite; would it comfort or scare her to death? Lord, give me a clue.

Sue