We spoke to people with pancreatic cancer who had a terminal diagnosis about planning for their death. Some people didn’t want to think about it but others were thinking about things like:
- Where they wanted to die
- Writing a Will and other practical preparations
- Signing a ‘Living Will’ (also known as an Advance Directive or ‘Do Not Resuscitate’)
- Planning a funeral.
A consultant explains that people may have little time to come to terms with death and dying, but…
Where people wanted to die
Many people wanted to die at home. Donna said that her husband would look after her as 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 realised that she might need a lot of nursing care to keep her dignity. She prepared for having to stay in bed by buying new sheets and nightdresses.
Ann acknowledged that in certain circumstances she might have to go into hospital, but she said…
Simon’s wife died at home. She was 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 wouldn’t change 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’d died. Ben said he would discuss the situation with the whole family and decide when the time came.
Others didn’t want to die at home but would prefer to die in a nursing home or 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 felt that death at home would be difficult.
David, for example, hoped to stay at home for as long as possible. He had a room downstairs and a walk-in shower, but thought he would probably have to go into a hospice as he got closer to death. 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.
Lesley wanted to die in a hospice: she didnt want her children and her husband to associate her…
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 knew 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. She stayed in the hospital, where she died peacefully. Looking back, Theadora decided that this had been the right decision.
Theadoras mother had her private room in the hospital and good nursing care, so Theadora felt it…
Making a Will and other practical preparations
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 he was told he had six months to live he sorted his things, sold some of them, improved his…
Lesley made memory boxes for her children. She also wrote birthday cards for their birthdays…
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 you can use to say what you want to happen with your medical treatment if you arent able to communicate.
Some people refuse all or some forms of medical treatment, and set out the circumstances in which this would apply. 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.
Ann had a living will. She believed that making her wishes clear made the situation easier for…
Dorothy explained why she did not want to be resuscitated and why she had signed a document…
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). An assisted death for Anthony’s wife would have been against their 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 have 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 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.
Anthony thought it was not necessary to keep people alive with extraordinary means but his…
Ann wanted a change in the law so that she could have the option of an assisted death here in the…
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.
Several people had begun making plans for their funeral and discussed it with friends or relatives.