Death and dying

This page contains information that may be confronting. It is written for people who need some strategies on how to cope and come to terms with the news that their time is limited because of the cancer.

Talking about death

• It is normal to feel that you do not want to talk about your own death.
• Coming to terms with dying is an ongoing process.
• Realising that death is not far away can be frightening and hard to believe.
• You will probably have a lot of mixed emotions.
• It can be helpful to talk about your fears and concerns with family and friends. This can also help them express their own feelings about you dying.
• If family or friends find it difficult to talk, a counsellor or psychologist can help you work through your feelings.

Saying goodbye

• People with advanced cancer say how important it is to tell others what they mean to them, to resolve old conflicts and to say goodbye to people.
• If you have children, you may want to write them a letter or make them a recording on tape, video or a camera. You could also create a slideshow or scrapbook of photographs.
• You may find this hard to do but it can be helpful and comforting for the children.
• If your children are very young, they'll understand your words and sentiments when they're older.
• Saying goodbye is a personal experience and you need to do what is right for you.

For more details, see Cancer Council's information on talking to children about cancer and dying.

How long have I got?

• Some people want to know how long they're expected to live. If it is important for you to know, ask your doctor.
• You might find doctors are vague about this. They can only estimate, based on the life expectancies of people with a similar cancer at a similar stage to you.
• It is likely to be tough if you are told that the time will probably be short.
• Even if it is only a matter of weeks, having that knowledge can help you get important things organised.
• If you live past the expected time, you can feel uneasy or unsettled not quite knowing what you should do now. It might help to talk about your feelings with your family, your doctor or a counsellor.

What is it going to be like?

• Many people say they don't fear death as much as the unknowns of dying. They also don't want to suffer.
• Death is as much a process as an event. The body slowly begins to shut down and many changes take place, such as:
  • frequent sleeping
  • skin becoming cooler
  • reduced appetite
  • muscles weakening
  • breathing sounding different.
• Loved ones can talk to and touch a dying person, even if they're unconscious. Touch is important for people, so it is likely to be comforting and nurturing.

Dying with dignity

• People often talk about dying with dignity. This means different things to different people, but for many it means dying with respect for who you are, what your wishes are, and the way you want to die.
• Talking about what you want with your family or palliative care team can help make your wishes a reality. For example, you may want to die at home or you may want to have only your partner with you.
• It can help to talk about death with  a doctor or nurse, particularly if you are anxious about it or are fearful of pain or suffering. They will talk to you about what is likely to happen and what can be done to make your final days easier.

Spiritual support

• Many people find comfort and strength in their spirituality.
• For others, having advanced cancer makes them question their faith. I
• It may help to talk about your thoughts and feelings with a pastoral care worker in the  palliative care team.
• They  and are trained to discuss spiritual issues, such as life's meaning, whatever your religion or whether you are atheist or agnostic.
• A pastoral care worker can also provide encouragement and companionship.
• If you have a religious belief, you may benefit from talking to your own priest, minister, rabbi or imam etc, and you may find spiritual support from others in your congregation.

Home, hospital or palliative care unit?

• Many people prefer the idea of dying at home. With the help of a palliative care team and family or friends, this may be possible.
• There may be reasons why you can't or don't want to die at home. Usually you would go to a palliative care unit but you may need to go to hospital.
• Discuss where you'd like to have end-of-life care with your family and find out their views. The palliative care team can also talk about your options and help you work out what will be best for you and your family.

LifeCircle is a not-for-profit organisation that supports carers looking after a person who wishes to die at home. For more information about the mentoring program, phone 1800 132 329 or see www.lifecircle.org.au.

Legal decisions

Most people like to get their affairs in order before they die. This may include making legal decisions about your property and your future care. You will have to consider:

• making a will
• whether you want to appoint someone as your power of attorney or enduring guardian
• whether you want to prepare an advance health care directive
• whether you want to plan your funeral or have some input.

For more details, see Cancer Council's information on your rights.