Finding out you are near the end of life
There are many practical and emotional issues to work through when you know you are reaching the end of your life.
Finding out you may be nearing the end of your life can be very difficult and distressing. You might find it hard to believe, even if you know your illness is getting worse. You may have strong and often overwhelming emotions that make it difficult for you to think clearly. You may need some time on your own, or with your partner, a family member or a close friend, to think about your future.
Some people find it easier to talk about their fears and worries with someone outside their family or friends. If you would like to do this, you can talk to:
- your GP
- your cancer doctor
- your specialist nurse
- a social worker
- a support organisation.
You will probably have many emotions when you find out you may be nearing the end of your life. You may feel tearful and upset, and unsure of how to cope with your feelings and emotions. You might find it hard to see normal life going on around you when your own world has changed so much.
You may be angry because you feel more could have been done to prevent your illness. Or you may think it could have been diagnosed at an earlier stage. It may feel unfair, and you may be unsure of what will happen in the future.
You might have some, or all, of these feelings. But as time passes, you may find you feel less distressed. With support from people around you, you may find you can think more clearly and cope better.
Many people with a serious illness want to know how long they might live for. This is a hard question to answer. Your healthcare team may be able to give you some idea of how many weeks or months you might live for, but they cannot be sure. You may live longer than they say or, unfortunately, you may live for less time.
It is normal to have times when you feel well and positive, and other times when you feel less well and have less energy.
Your future may be uncertain, but it is often helpful to plan ahead and make the most of the days when you feel well. You may want to plan some nice things with your family and friends, or just spend time with them.
When you are reaching the end of your life, partners, family and friends become even more important. They can provide support and reassurance to help you cope with what is happening.
But terminal illness can sometimes make relationships difficult. Many people find it hard to know what to say. You may find people react in unexpected ways. Some people may avoid talking about your illness completely. Others may be overly cheerful, and this can make it hard for you to tell them how you feel.
Close family and friends may be overprotective. You might find this irritating at times. Sometimes they may feel like strangers, at the time when you need them most.
Remember that people around you are likely to be shocked by the news. People close to you are also dealing with powerful emotions and may need support themselves. Their feelings and emotions will also change over time.
You may find your relationships get stronger as you, and the people close to you, value the things that are important. The illness can also be a chance for you to contact people you have not spoken to for a while, and for others to contact you. It may be an opportunity to resolve past arguments or bad feelings.
If you have a partner
Sometimes partners try to protect each other from the truth by pretending it is not happening. But talking honestly with each other about your feelings can help you both cope with sadness, anxiety and uncertainty. You may find your relationship gets stronger as you deal with the challenge of your illness together.
It is important to keep your relationship as normal as possible. If you have always been close and talked a lot, there is no reason to stop doing this. When you do not know what to say, a hug or holding hands can be very comforting for both of you.
If you have always argued, do not feel you should change this. There will probably be times when you do not get on well. If you argue, having short breaks from each other can help you feel calmer and think more clearly.
You might feel you have to be strong and be the one to start any hard conversations. You may feel you need to support other people, even though you are the one who is ill. But if you are unwell or feeling low, it can be very hard to do this.
We have more information about talking about cancer.
Talking to children
It is never easy to tell children or grandchildren that you are very ill and nearing the end of your life. But it is often best to be as honest with them as you can, and give them information they can understand.
We have more information about:
You may value your independence, especially if you live on your own. But being ill might make you feel lonely and frightened. It may be very hard to keep positive if you are on your own.
People who care about you will want to help in any way they can. It is ok to ask for and accept their help. You may have family members or friends who can spend time with you. It can be helpful to have someone to talk to who will listen to your worries and fears.
Others may be happy to help in more practical ways, such as helping with shopping, housework or the garden. You could make a list of practical things that would make your life easier. If people offer to help but are not sure what to do, you can show them the list. They can then choose to do something that will help you.
If you do not have anyone to help you, talk to your:
- social worker
- district or community nurse.
They can tell you what help and support is available from health and social care professionals and voluntary organisations.
Approaching the end of your life can be a challenging and hard time for you and your family and friends. You may get all the emotional support you need from your family, friends and healthcare team. But some people find it easier to get support from someone they do not know so well.
Some people may need more specialised help in dealing with their emotions. This might be from one of the following professionals.
Counsellors are trained to listen and help people talk through their problems. They will not give advice or answers, but can help you find your own ways to solve problems. Talking with a trained counsellor can help you express and understand your feelings. It can also help you find ways to deal with these feelings or the problems they relate to.
There are different ways to find a counsellor:
- GP practices, hospitals and hospices often have their own counsellors. If they do not, they should be able to refer you to one.
- Our cancer support specialists can tell you about counselling in your area.
- The British Association for Counselling and Psychotherapy can give you details of counsellors in your area.
Your family might also find counselling helpful if they are finding it hard to cope with their emotions.
Clinical psychologists are trained in understanding how people think, feel and behave. They are specialists in providing psychological and emotional support to people with advanced cancer. For example, they can help if feelings of anxiety or depression become overwhelming, or if you are having relationship problems. They can sometimes offer support to carers and family members.
Clinical psychologists are often part of the hospital’s cancer (oncology) services or the palliative care team.
Spiritual care coordinator or chaplain
Spiritual care coordinators or chaplains offer spiritual care and support. Even if you do not have a spiritual or religious faith, you may want to talk to a chaplain about how you are feeling.