[Doris]

I've lived with my cancer for a long time, and I recently had my fourth recurrence. My cancer is now very advanced, and the only treatment left is experimental. I've talked to my health care team. They've told me that the side effects of the treatment are pretty serious. My doctor says he's not sure it will help me very much. After all of the surgery and chemotherapy I've had, I just don't want to go through chemotherapy again -- especially if it has little chance to help me. I realize I'm going to die sometime in the near future and I've made my peace with that. I'm very religious and count on God to get me through.

[Doris]

The problem is my three children. They don't like the idea of me just "giving up." They make me feel like I'm letting them down. My oldest son even acts like he's mad at me. The other day he told me that I should think about my grandchildren -- didn't I want to live to see them grow up? Well, I was just heartsick at this. I adore my grandchildren and if it was possible to live long enough to see them raised, you can be sure I'd do anything to make it happen. I was so upset after our conversation. For several days afterwards, I even thought about changing my mind. But, I've just got to be realistic now.

[Doris]

I decided I needed some help to solve this problem -- that I needed to talk to someone outside the family. I thought about my minister and how helpful he was when my husband, Ed, died five years ago. I called him and asked if he could meet with me. We had a long talk and he helped me understand the problem better -- that my children were afraid of losing me, too, and that I need to help them prepare for my death while at the same time living as fully as we can and spending time -- good time -- together. He said we are experiencing what is called "anticipatory grief" -- we are grieving the fact that we are going to lose one another and that we need to talk about these feelings. I also told him that I did not want to become a burden on my family -- that I had always been fairly independent, and that my children have their own lives to lead. At the same time, I knew I couldn't get through this without the help and support of my children.

[Doris]
 
So, we decided on a plan that has several steps. I called the local hospice and went and met with them. Since our town is so small, I already knew two of the women who worked there, and they have been very kind to me. They described their services. They are what is called a "home care hospice." They provide care so you can stay in your home. They also told me about how I select the hospice Medicare benefit that covers nursing care and medications, including medications for pain, if I should need them. They said they would get in touch with my doctor about a referral. I know my doctor will agree. She works part-time with the hospice program.

[Doris]

The people at the hospice also agreed to help me set up a meeting with my children. The hospice nurse, social worker, and pastoral counselor would all be present to help me explain my choice and what we can expect. And, what role my children will need to play.

[Doris]

The next part of my plan was to get my children together to tell them about my final decision. My birthday was coming up -- my 79th! I sent a note to each of my children asking them to come to my house on Thursday evening for an early birthday dinner. I asked them not to bring any presents. At first, my daughter objected -- she said it would be easier if they just took me out to our favorite restaurant for a celebration. "Thank you," I said, "but no." I wanted them to come to my house.

[Doris]

They were all able to come, and we had a nice meal together. I had cooked many of their favorite dishes. When dinner was over, I said I wanted to tell them about the best birthday present they could give me. What I wanted was their blessing about my choice to forego any more treatment for my cancer. I said that I wanted them to help me have the best quality of life that I could possibly have in whatever time I had left.

[Doris]

Then, I told them that I had chosen to enter a hospice program and that I would like all of them to come with me to a meeting there. I said I knew that they were afraid of losing me, and that I felt the same way about leaving them. But, I also reminded them that together we had faced difficult times in the past -- when their father died -- and that we would face the future in the same way -- together. I also said that we had other decisions that we needed to make and that I would ask each of them to help me with specifics, like getting my legal and financial affairs in order… and making funeral arrangements. I told them that I did not want to become a burden to them. We talked about what services the hospice could offer, including what they called "respite services" where I could enter the hospital for several days if my children were unable to help me during a short time. They all said we would never need to use the respite option, but I still wanted them to know that was available to us.

[Doris]

We did cry a little, and at times the conversation was hard. But, we were finally able to talk fairly openly about my situation and clear the air. We seemed like we were working together as a family again. I must say, it was a very good birthday indeed.

[Narrator]

Doris is obviously a very brave and strong person. But, the key point here for all cancer survivors is that, if you can set your goals and are willing to put some effort into it, you can find ways to overcome a seemingly large obstacle by overcoming all the small ones, one at a time. Doris did this by identifying the problem, getting the facts, thinking it through carefully, and carrying out her plan. She and her family also took the time to think about how they had solved previous problems. This experience served them well.

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