Pancreatic Cancer

Making plans for death

Some people we interviewed felt optimistic about their treatment and were looking forward to getting back to normal activities, but some of those who knew that they had a bad prognosis did not want to think about the future (see ‘Everyday life and facing the future’). However, others were preparing for their death.
Many people wanted to die at home. Donna, for example, said that her husband would look after her, that he was her ‘one-to-one nurse’. She said that it would be more comfortable at home than in a hospice, and she wanted her things around her. Ann wanted to stay at home too, but acknowledged that she might need a lot of nursing care to keep her dignity. She decided to prepare for being confined to bed by buying new sheets and nightdresses.
Simon’s wife died at home. She had made it quite clear that she did not want to go into a hospice and wanted to stay at home. It had been hard for him and his children but he said he would not have changed what had happened.
 
Ben wanted to die at home. On the other hand he was aware that his children might not want to live in a house where he had died. Ben said that when the time came he would discuss the situation with the whole family and then decide.
 
Others, however, did not want to die at home but would prefer to die in a nursing home or in a hospice. Some didn’t want the family to associate their death with the family home. Others did not want to burden their family or friends. Some recognised that death at home would be difficult. David (Interview 09), for example, hoped to stay at home for as long as possible. He had a room downstairs and a walk-in shower, but recognised that as he approached death he would probably have to transfer to a hospice. He said that ‘would be the most graceful way’ to die. Lesley wanted to die in a local hospice, but she knew that it had only 10 beds. She said that even going into hospital would be better than staying at home.
Many people die in hospital. Anthony’s wife, Martine, died peacefully in hospital with her family beside her. She trusted the oncology team and they cared well for her. Anthony said that they had never discussed where she was going to die. However, he suspected that she wanted to die at home or in the hospital, where she trusted the doctors, and not in a hospice.
 
Theadora’s mother had hoped to die in a hospice but while she was in hospital her condition deteriorated rapidly and the long ambulance journey to the hospice could have been too stressful, so she stayed in the hospital, where she died peacefully. Looking back Theadora decided that this had been the right decision.
People made other preparations for death. Some made sure that their will was in order. Tony decided which member of the family would eventually have his bike, his car and other valuables. Another man sold some of his treasured possessions. He wanted to make sure they were sold to people who would appreciate them, not left for a car boot sale or a house clearance. He also repaired the house so that his wife would not have to worry about practical issues. Others made memory boxes and wrote cards for children to have on future birthdays.
When Anthony’s wife was dying they both found comfort in their religious beliefs and the thought that she was ‘moving from one world to another’. His wife had some counselling and spent time talking through the meaning of death.
 
People made other plans too. Some explained why they had signed a ‘Do not resuscitate document’ – also called an ‘advance directive’, an ‘advance decision’ or a ‘living will’. An ‘advance decision’ is a legally binding written document that indicates the specific wishes of a person to refuse all or some forms of medical treatment, and the circumstances in which this would apply. (See Compassion in Dying's website for how to make an ‘advance decision’). People may not want to sign an ‘advance decision’. Theadora said that her mother would not have wished to sign one. Her mother had made it clear that she wanted to continue treatment for as long as possible if it meant a few more hours of life.
A person cannot use an ‘advance decision’ (‘living will’) to ask a doctor to end their life. A few people discussed the issue of assisted dying (sometimes called voluntary euthanasia). Anthony explained that an assisted death for his wife would have been against his religious faith. Steve also had a strong Christian faith. He was confident that the palliative care team would be able to deal with any pain he might experience as death approached. However, he recognised that the issue of assisted dying isn’t ‘black and white’ and he was still thinking about it. Ann felt very strongly that she should have the option of an assisted death in the UK. She did not want to go to Dignitas in Switzerland where assisted death is legal, but wanted to die at home with her family around her. She said that she would approach her death in a ‘better frame of mind’ if she knew that an assisted death was an option. She wanted to die with dignity and have the option of ending her life when she decided it was the right time to die.
Several people had begun making plans for their funeral and discussed it with friends or relatives.

See also our sections on living with dying, or caring for someone with a terminal illness.

Last reviewed June 2015.
Last updated June 2013

 

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