Death And Dying

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0 height="100%"><tr> <td valign="top" width=200 BGCOLOR="#003333" TEXT="#F7F7FF" background="067d8c00dduajq.jpg"> <div> <B>Death And Dying</B></div> <div> <A HREF="id207.htm" TARGET="_top" TITLE="Carers"><U>Carers</U></A></div> <div> <A HREF="id208.htm" TARGET="_top" TITLE="Symptom Control"><U>Symptom Control</U></A></div> <bR> <bR> <DIV ALIGN="LEFT"></DIV> <div> Click on the question to go to the answer</div> <div> Click on the Top link (at bottom of answers) to return to the questions</div> </td> <td valign="top" BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <FONT SIZE="5" COLOR="#0066FF" FACE="Arial" ><B>Don't Say That Word</B></FONT><FONT SIZE="1" COLOR="#333399" FACE="Arial" >   </FONT>  |     <A HREF="index.htm" TARGET="_top" TITLE="Dont Say That Word"><U>home</U></A></div> <div> back to  <A HREF="id166.htm" TARGET="_top" TITLE="Living With Cancer QA"><U><B>Living With Cancer Q&A</B></U></A></div> <div> Death And Dying</div> <div> <B> <A NAME="top"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></B><B>Questions</B></div> <bR> <div> <A HREF="#1___your_question_shows_a_very" TITLE="Death And Dying"><U><U>1. My husband has terminal cancer and is coming home from hospital. He wants to die at home and I want this too. We are both coping quite well with the situation but I realised that I don't know what to do when the end comes- who do I contact, who do I notify? </U></U></A></div> <bR> <div> <A HREF="#2___macmillan_cancer_relief_is_a_uk" TITLE="Death And Dying"><U><U>2. What is a Macmillan nurse? (UK)</U></U></A></div> <bR> <div> <A HREF="#3___a_diagnosis_of_leukaemia_is_always" TITLE="Death And Dying"><U><U>3. My mother has been diagnosed with AML and has decided not to have chemotherapy. What is going to happen? How will she be? How will she die?</U></U></A></div> <bR> <div> <B>Answers:</B></div> <bR> <div> <B> <A NAME="1___your_question_shows_a_very"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></B><B>1.  </B>Your question shows a very well-adjusted approach to a desperately difficult and distressing situation. </div> <div> The practical answer is that when someone dies at home you should let your GP know at once. They, or someone who is covering for them, will then be able to come and confirm and certify the death. Once this has been done you can then call the undertaker who will not only see to the laying out of your husband's body and all the funeral arrangements but will be able to answer all your questions about what to do next.</div> <bR> <div> Most undertakers do operate a 24 hours service but if your husband dies during the night there is no need for you to call them immediately if you would rather wait for a few hours.</div> <bR> <div> As it is your GP, or one of his or her colleagues, who actually has to confirm and certify death it is important that you make sure they are aware of your husband's situation (the hospital should have notified them but it is best to double check). Ideally it would also help if your husband could visit your GP, or your GP come and visit him at home, once he is back from hospital, if they have not been seeing him regularly. </div> <bR> <div> When your GP confirms the death he or she will give you a medical certificate of the cause of death, together with a slip of paper 'Notice to informant' which tells you about the information you will need to register your husband's death. Your GP would also let you know if a post-mortem was necessary, although this is not usually needed when death is due to cancer.</div> <bR> <div> Obviously even if you know your husband is dying and feel you are managing to cope, the end can still come as a shock and leave you, temporarily at least, confused and bewildered. If you have a friend or relative who you can contact at that time to be with you through those first few hours it might be very helpful. </div> <bR> <div> <A HREF="#top" TITLE="Death And Dying"><U><B>[Top]</B></U></A></div> <bR> <div> <B> <A NAME="2___macmillan_cancer_relief_is_a_uk"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></B><B>2.  </B>Macmillan Cancer Relief is a UK wide charity devoted to supporting people living with cancer. </div> <div> For man years the charity has provided funds for Macmillan nurses. This means that patients do not have to pay to see a Macmillan nurse. Macmillan Cancer Relief pays the salaries of these nurses for three years and then the NHS takes over their funding, although they continue to be known as Macmillan nurses. </div> <div> There are almost 2000 Macmillan nurses. Most of them are based in the community and see patients at home but some work in hospitals or hospices. </div> <div> Macmillan nurses are specially trained to help cancer patients and their carers in a number of ways. These include</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">explaining the best way to control pain and other symptoms </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">advising patients about the different treatments available and guiding them through those treatments, including helping with the control of side-effects </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">spending time with patients and their families to give emotional and psychological support </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">advising on ways of getting practical help, including advice on benefits and other financial matters. </div> <bR> <div> Macmillan nurses are available to people at any time after a cancer has been discovered and are not just involved in the support of those who are terminally ill or dying. They often give invaluable support to people with curable cancer as they go through their treatment journey.</div> <div> If you think you would like to see a Macmillan nurse then all you have to do is talk to your GP or your hospital medical team (either the doctors or the nurses) and they will arrange it for you.</div> <bR> <div> <A HREF="#top" TITLE="Death And Dying"><U><B>[Top]</B></U></A></div> <bR> <div> <B> <A NAME="3___a_diagnosis_of_leukaemia_is_always"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></B><B>3.  </B>A diagnosis of leukaemia is always a great shock to patients and their families. Your mother's doctors are there to answer her questions about her illness and to give her information about possible treatments and their chances of success. Once a patient knows all the facts, the decision to have treatment or not is ultimately theirs. </div> <div> Although your mother has decided not to have chemotherapy it is important not to feel that there is nothing else that can be done for her. Chemotherapy is just one part of the care for somebody with AML. She will continue to be closely monitored by her doctors so that any unpleasant symptoms which develop can be controlled. This includes symptoms like tiredness, nausea and breathlessness, for example. </div> <bR> <div> Her doctors may also wish to ask for the help of the palliative care doctors and nurses who specialise in symptom control. They can liaise with her GP, district and Macmillan nurses and the local hospice if necessary.</div> <div> The natural course for somebody with untreated AML is very variable. The bone marrow will remain abnormal and unable to make normal red cells, white cells and platelets. If she is anaemic, she may be tired and breathless and the low platelet count will mean she may have problems with bleeding and bruising. Because of this she will need transfusions of red cells and platelets. She will also be at risk of getting infections. The blood may start to become thick and sludgy from the increasing leukaemic white cells. This will affect the blood supply to the brain (causing tiredness, confusion, weakness, and headache) and to the lung (causing breathlessness). Importantly, pain is very uncommon in this situation. </div> <bR> <div> Sadly, he average life expectancy of a person with untreated AML is usually only a few months. However, some people may live for 3 to 6 months from their diagnosis. Inevitably most people develop a serious infection or a bleed that proves fatal. This can happen suddenly, or more commonly as part of a general decline as the white count rises. It is important to discuss these possibilities with your mother and her doctors so that everybody knows her wishes regarding the last stages of her life, for example whether she would want to be given antibiotics or admitted to hospital if she developed a serious infection. </div> <bR> <div> With the support which is widely available, the great majority of patients with terminal leukaemia can be cared for in the surroundings of their choice in comfort and dignity</div> <bR> <div> <A HREF="#top" TITLE="Death And Dying"><U><B>[Top]</B></U></A></div> <bR> <bR> </td> </tr></table></body>