Hospice or continue our fight?????

I am sure you do have the right to refuse hospice.  Whether or not to continue the fight is such a hard and personal decision.  I am sure you will be given better suggestions than I can give, but we do have Hospice helping us right now (for different reasons) and it is a great organization.

I hope others can point you in a better direction than I can

I am sure you do have the right to refuse hospice.  Whether or not to continue the fight is such a hard and personal decision.  I am sure you will be given better suggestions than I can give, but we do have Hospice helping us right now (for different reasons) and it is a great organization.

I hope others can point you in a better direction than I can

Hi,

You can refuse Hospice. And Terra is also right about continuing the fight or not, is highly personal and is up to the patient. You say he is alert and has a clear mind, so based on what you write, it seems he wants to continue. Should he decide he has had enough, that will also be his call.

I've been a Hospice Chaplain, and I love Hospice. My husband is a pharmacist and he can't stand Hospice. It really isn't for everyone. But they are great when the end really is nearing and pain management is crucial. Also, their chaplains are top notch on end-of-life counseling for patient and family alike.

You have a lot of "we" here. I know this is a difficult time for all of you, but I hope you are all taking your cues from your loved one. You say your family can look after him. Are any of you able to give him shots, monitor his pain and increase morphine (the usual pain killer at this time), monitor his oxygen if he's on it, etc…seriously. These are all things to think about because there's much more involved than keeping him clean. Can you recognize when systems start shutting down and how to handle that? All things Hospice does. Do you have a qualified nurse, or doctor, who'll come by your house as necessary to take care of these and other issues? Again, things to think about and get in place if you choose not to go with Hospice.

Also, while your loved one is alert and clear headed and wants to fight, could he or she benefit from talking with someone who will help them come to grips with dying and making sure their business is taken care of, will written, etc? Talking with someone about death and dying may also help your loved one get a better idea if they want to continue fighting or not.

I would also talk with another doctor at Dana Farber about their blood policy and get a second opinion on that. There are other melanoma specialists there who have been there longer.

Ultimately, you will have to face facts and they probably won't do blood forever. The doctors deal with and see end-of-life all the time. They will be more matter-of-fact about it than we would like. Money probably isn't the issue to tell you the truth for the doctor. There may well come a time when insurance will refuse to cover these procedures though. 

It might be very helpful to you and your family, patient included, to sit down with the "head of melanoma" at Dana Farber and discuss your loved one, their policies, and your options.

Watching cancer do this to someone you love is horrible. I know you want to do your best by him or her and walk them through this time. I'm sorry you are all going through this. Prayers. Lord, in Your abundant mercy and wisdom. Amen.

Grace and peace,

Carol

Hi,

You can refuse Hospice. And Terra is also right about continuing the fight or not, is highly personal and is up to the patient. You say he is alert and has a clear mind, so based on what you write, it seems he wants to continue. Should he decide he has had enough, that will also be his call.

I've been a Hospice Chaplain, and I love Hospice. My husband is a pharmacist and he can't stand Hospice. It really isn't for everyone. But they are great when the end really is nearing and pain management is crucial. Also, their chaplains are top notch on end-of-life counseling for patient and family alike.

You have a lot of "we" here. I know this is a difficult time for all of you, but I hope you are all taking your cues from your loved one. You say your family can look after him. Are any of you able to give him shots, monitor his pain and increase morphine (the usual pain killer at this time), monitor his oxygen if he's on it, etc…seriously. These are all things to think about because there's much more involved than keeping him clean. Can you recognize when systems start shutting down and how to handle that? All things Hospice does. Do you have a qualified nurse, or doctor, who'll come by your house as necessary to take care of these and other issues? Again, things to think about and get in place if you choose not to go with Hospice.

Also, while your loved one is alert and clear headed and wants to fight, could he or she benefit from talking with someone who will help them come to grips with dying and making sure their business is taken care of, will written, etc? Talking with someone about death and dying may also help your loved one get a better idea if they want to continue fighting or not.

I would also talk with another doctor at Dana Farber about their blood policy and get a second opinion on that. There are other melanoma specialists there who have been there longer.

Ultimately, you will have to face facts and they probably won't do blood forever. The doctors deal with and see end-of-life all the time. They will be more matter-of-fact about it than we would like. Money probably isn't the issue to tell you the truth for the doctor. There may well come a time when insurance will refuse to cover these procedures though. 

It might be very helpful to you and your family, patient included, to sit down with the "head of melanoma" at Dana Farber and discuss your loved one, their policies, and your options.

Watching cancer do this to someone you love is horrible. I know you want to do your best by him or her and walk them through this time. I'm sorry you are all going through this. Prayers. Lord, in Your abundant mercy and wisdom. Amen.

Grace and peace,

Carol

It really is all up to the patient, if he is clear minded.  We will all die someday, whether from melanoma or something else.

Our friend, who had stage 4 lymphoma, refused to believe he was dying and therefore didn't speak with his wife about selling the house, funeral plans or how to deal with the small children left behind. That was faith turned into foolishness. Even when his body gave clear signs that he was at the end, he refused to believe he would die.

Even thou her husband would not admit to dying, the wife called hospice and she thought that they were very helpful.

There is a time to end treatment. Big questions with no easy answers.

Nicki,Stage 3b, scalp

It really is all up to the patient, if he is clear minded.  We will all die someday, whether from melanoma or something else.

Our friend, who had stage 4 lymphoma, refused to believe he was dying and therefore didn't speak with his wife about selling the house, funeral plans or how to deal with the small children left behind. That was faith turned into foolishness. Even when his body gave clear signs that he was at the end, he refused to believe he would die.

Even thou her husband would not admit to dying, the wife called hospice and she thought that they were very helpful.

There is a time to end treatment. Big questions with no easy answers.

Nicki,Stage 3b, scalp

Talk to your local hospice.  A dear friend that I met on this board, Lynn went into hospice care  last summer. She not only continued receiving blood transfusions but she had 2 weeks of IL2 during that time.  There are several on this board that are under hospice care but still get treatments. It's all in the agreement that is put together. 

Hospice believes in keeping you comfortable. Receiving blood is part of that. My mother was in hospice care in 2000. The Dr forced our hand telling us that there was no more treatment that he would give her but he would make sure she was comfortable. 

Thinking of your family,

Linda

Talk to your local hospice.  A dear friend that I met on this board, Lynn went into hospice care  last summer. She not only continued receiving blood transfusions but she had 2 weeks of IL2 during that time.  There are several on this board that are under hospice care but still get treatments. It's all in the agreement that is put together. 

Hospice believes in keeping you comfortable. Receiving blood is part of that. My mother was in hospice care in 2000. The Dr forced our hand telling us that there was no more treatment that he would give her but he would make sure she was comfortable. 

Thinking of your family,

Linda

This might help you better know the services Hospice offers:

http://dying.about.com/od/whatishospice/a/whatishospice.htm

Because your loved one is going to Dana Farber and these large centers often offer their own palliative care, I looked that up for you and here's what they offer:

http://www.dana-farber.org/Adult-Care/Treatment-and-Support/Treatment-Centers-and-Clinical-Services/Pain-Management-and-Palliative-Care.aspx

Remember, Hospice is just one palliative care program.

Grace and peace,

Carol

This might help you better know the services Hospice offers:

http://dying.about.com/od/whatishospice/a/whatishospice.htm

Because your loved one is going to Dana Farber and these large centers often offer their own palliative care, I looked that up for you and here's what they offer:

http://www.dana-farber.org/Adult-Care/Treatment-and-Support/Treatment-Centers-and-Clinical-Services/Pain-Management-and-Palliative-Care.aspx

Remember, Hospice is just one palliative care program.

Grace and peace,

Carol