End-of-Life Care
End-of-life care is when the care team of a person with advanced cancer determines that additional treatment would no longer help or may even cause harm. At this point, cancer treatments often stop, but the person’s care continues. This care focuses on improving their quality of life, making them comfortable for their last months or weeks. It can also involve emotional support for their loved ones.
What is hospice care?
Hospice care is a type of care that focuses on the quality of life for people at end-of-life and their caregivers. Hospice care treats the person and their symptoms, rather than trying to treat the cancer itself. It focuses on allowing a person with incurable cancer to live as comfortably and fully as possible. Hospice care is usually for a person who is expected to live 6 months or less as determined by their care team.
Hospice care is family-centered, meaning family, caregivers, and the person at end-of-life are all involved in the care and in making decisions.
Hospice care is given by a team of healthcare professionals from a hospice service. This can happen:
- At home (called outpatient hospice) with care provided by loved ones with visits from the hospice team
- At a hospice facility (called inpatient hospice) by dedicated hospice professionals
Ask your hospice care team what options are available in your area.
Hospice services may include:
- Comfort care – Comfort care treats symptoms and side effects to relieve pain, stress, nausea, and other side effects so a person is comfortable. This can be very helpful in the last stage of life.
- Spiritual care – This can help people meet spiritual needs or religious beliefs. People may want help thinking about what death means to them, how to say good-bye, or need help with certain religious ceremonies.
- Family meetings – A member of the hospice team can lead meetings with family members to keep them informed about a person’s condition and what to expect. During these meetings, people can share feelings, learn about the process of dying, and get emotional support. The team can also keep in touch with family and caregivers informally several times per week.
- Coordination of care – The hospice team coordinates and supervises all care. They make sure all services share information, such as doctors, pharmacists, inpatient facilities, clergy, and funeral directors. If there are any issues during end-of-life care, loved ones can contact the hospice team for help.
- Respite care – For people who are being cared for at home, this type of care gives caregivers a break. For a short time, the person with cancer will stay at an in-patient care facility. The hospice team at the facility will care for them, giving family and friends some time to themselves.
- Bereavement care – The hospice team helps family and friends through the grieving process after their loved one has passed away. This care is often provided for about a year after the loved one’s death.
Preparing for end-of-life
Many of us believe it’s important to prepare for the end of life, but very few of us prepare for what it means to live with a serious illness or need support later in life. Being prepared can help people get the support and care they need as soon as it’s needed.
This is called “advance care planning.” Having a plan allows us to share our values and what is most important to us – even when we are too ill to speak.
Advance directives
Experts recommend that people with advanced cancer complete advanced directives. Advance directives are legal papers that state a person’s wishes for their treatment and care. They can also designate a person to be their decision-maker for care when they are too sick to decide. People have the right to make decisions about their own treatments, and advance directives allow them to do this.
Advance directives can include these forms:
- Durable medical power of attorney: A document that names a person to make healthcare decisions for a patient if they can no longer make decisions. The patient chooses this person, and they are called a “healthcare proxy.” This should be someone who knows you well and will carry out your wishes.
- Durable financial power of attorney: A document that names a person to manage finances and property for a patient. This person can pay bills, make bank deposits, and collect insurance benefits for a patient.
- Living will: A document that details what kind of healthcare a person wants if they can’t speak or make decisions for themselves.
Durable power of attorney directives can be a good idea even if a person isn’t preparing for end of life. For a durable financial power of attorney, the person named can make sure their bills are paid if they’re in the hospital for a long time.
Talking about end-of-life
The greatest gift we can give those we love is the opportunity to discuss what’s important to us when we’re ill, and to plan for that time. The more we talk about our wishes at the end of life, the more we can plan for it. For example, this could include questions such as:
- Where do I want to be when I die?
- Who do I want to have with me?
- Do I want any heroic measures taken to prolong my life? This may include CPR or high doses of medicines.
- Are there any specific religious/spiritual requests?
Studies have shown that people who are ill who talk about their end-of-life choices are more likely to feel in control of their situation, suffer less, and to die in peace. These discussions also actually improve anxiety and depression – for the person who is ill, but also for those who love and care for them.
People preparing for end of life can talk about their choices with:
- Their cancer care team – They can ask about their options and share their decisions for end of life. It’s important for the care team to know about preferences, including where someone would like to get care, or any cultural, religious, or spiritual beliefs or values.
- Their loved ones – They can share their treatment decisions and medical care wishes, including their reasons for their choices. If their loved ones know their choices, they can follow what is best for the person who is ill.
Watch presentations from experts to learn more:
References:
Information on this page last reviewed: January, 2025
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