When my mother-in-law was diagnosed, the doctors told my husband (not her) that she probably had around 2 to 4 months left, although they made it clear that that was a rough estimate and that a lot of factors could shift things in one direction or the other.
Well, yeah. Of course most of the stories in this thread are going to be second-hand. It’s kind of the nature of the beast: people who have been given a terminal diagnosis are a lot less likely to be alive to tell the story.
My husband’s oncologist must have considered himself quite the card. He gave us 2 options (and I was in the room with my hubby)-my husband would live about 18 months or a year and a half. Hardy Ha Ha. He in fact did live another 18 months almost to the day.
Oh, and one more thing, since I’m on the topic (maybe I should start another thread) -
Palliative and hospice care are often confused for one another, which is one of the reasons so few people get palliative referrals, even if they should.
As I said above, palliative care focuses on relieving the symptoms of disease and the side effects of treatment, and a person can be anywhere in the treatment process to get palliative care.
Hospice care is the branch of palliative that eases the discomfort of those who have estimated 6 months or fewer to live. At that point treatment for the main disease has probably stopped; it’s just a question of making the patient comfortable.
Anyway, yay modern medicine!!!
But, in billable hours, won’t every patient live ten more years…? /s
I have two different experiences with this.
When my mother was killed in a traffic accident, by the time we got to the ER, she was unconscious and not expected to live more than a couple of hours.
On a different time frame, my mother in law was diagnosed with Parkinson’s and the doctor initially said she would probably live another 10 or so years based on common progression of the disease. At one point in her decline, she spent a few days in the hospital with pneumonia and looked to be healthier than she had been for years. The doctors warned us that this wouldn’t last and that we probably had only three weeks or so to say goodbye.
With all three of these predictions, the doctors were right within about a 10% margin of error.
I am paraphrasing what the doctors said, especially on the 10-year progression. I know that it was stated with a statistical qualification, though I don’t remember the exact wording. But the three-week prediction really was stated as “She is not likely to live more than about three weeks. If anyone wants to say goodbye, they need to get here as soon as possible.”
Sounds like you have nothing to worry about anyway. Whenever you can’t pay the bill they give you another six months.
Isn’t that kind of an incredibly dick move, or am I missing something?
I have a good friend with severe heart and artery problems. He was given no more than 6 months almost 20 years ago. No Dr. has given him more than a year to live since then. They keep telling him there is no more they can do and he keeps finding Dr’s who are willing to try and succeed. He is at the point right now where he takes about 20 steps and is completely breathless and ready to collapse. 80 years old. He never stops pushing himself. Meeting him for dinner tonight in a few hours.
I had a relative diagnosed with tsutsugamushi disease (scrub typhus). The physician gave her 12 hours to live, advising her to watch her favorite Thursday night TV show live instead of taping it to watch later. She took his advice, enjoyed her final program and expired shortly afterwards.
True story.
*Well no, I made it up, but it’s a great story.
My MIL has been pretty ill for quite some time. One difficulty we’ve had is the hesitation of anyone to give us clear ideas of what to expect. My wife and her family were interested in that info in order to make necessary arrangements.
While doctors have not given any specific life expectancy, for at least 5 years they have consistently intimated that she was not expected to last more than 6-12 months. My wife and her family have desired such information as they made decisions such as hiring live-in care, moving her to assisted living, etc. Not sure how much they would have done how differently, but I wonder how things could have been done differently if we’d known this was going to be such a lengthy decline.
I recall an essay by Stephen J. Gould in which he discussed the statistics behind life expectancies. He beat his cancer prognosis by several years. As I understand it, if life expectancy is 6 mos, that bell-curve is skewed right towards people who live far longer, with a left limit of 0 for people who die the next day. So he just figured he’d be one of the outliers on the right.
Is it more accurate the closer to the end?
The hospice nurse saw my MIL on a Monday, and said it would be two more weeks. When she came again on Thursday, she said she’d be surprised if she survived the weekend. She was right…she died Sunday night.
I can imagine patients can either rally or decline depending on circumstances. Certainly some can beat the odds, but I think there comes a point where it’s not possible and medical professionals can recognize the final stages as the body winds down.
I’ve known people to been told a time line, usually the dr is wrong.
I had an alcoholic uncle who was told he’d die young if he didn’t stop drinking. He lived another 25 years of heavy drinking.
I knew a woman who was told to stop drinking, that one more beer would be her last. She stopped for a while, went out and had two beers and died.
My ex-bil was badly injured, got backed over and then ran over by a pickup truck. First the doctors said he wouldn’t last the night. He did. Then they said he’d be in a vegetative state for the rest of his life, he woke up. Then they said he’d never walk again, he did. Then they said he’d never work again. It took him 18 months but he went back into construction work.
Then he got pancreatic cancer. First he was given 9 months, then 6 months, then 3 months and he beat the cancer. His doctor calls him the miracle man.
Now he has liver cancer. I think he won’t make it this time, but nobody has given him a time line. No reason to, it’s not like he’s going to listen to them.
I think so, yes. Hospice isn’t my area of expertise, but somewhere around here I have an excellent teaching pamphlet for families, and it outlines some of the physical, mental and emotional changes that progress fairly predictably in the last weeks. Things like, “two months* before death, your loved one may spend more time talking about the past, even as their memory and understanding of current events dwindles,” and “two weeks** before death, you may notice your loved one sleeping a lot more, or staring off into space.” And of course we recently talked about that “rally” that many people have a day or two before death, where they have more energy and less pain and are often more talkative and sometimes even hungry. Of course everyone has their own process, but when you spend a lot of time around dying people, patterns become evident.
*I’m not sure about that number
**I’m fairly certain of that number
My brother in laws oncologist didn’t give him any timelines or any survival statistics. I suspect he wasn’t good at that part, but I also suspect he read the room and figured they didn’t want to know, and would go into deep denial and it wouldn’t do any good anyway.
My mother in law found out how long he had to live when the decided to move him to hospice since the hospital couldn’t do any more and he didn’t want to die in a hospital. My mother in law had internalized “you don’t move into hospice until you have less than six months to live” as “when we move you to hospice you have six months to live” and said to the doctor “we will see you on Monday.” He said “I don’t think so, I don’t think he’ll last that long.”
Well, I was in the room when my dad’s doctor gave the diagnosis. (Pancreatic cancer. Given my dad’s age and pre-existing conditions, treatment was as likely to be fatal as the cancer itself.) Dad asked for a timeline. The doctor said probably a month. Dad died almost exactly a month later.
Reading that on the page, it sounds a bit harsh. But the doctor delivered the news about as gently as was possible, given the news he had to deliver. Trying to beat around the bush, and evade the harsh realities, would have made things worse. I think it was rougher on the doctor than it was on my dad.
Hospice nurses are wonderful people. Dying people can be a handful. Mom and I were at our wit’s end. The hospice sent a nurse to the house, and in a couple of hours, she had things organized, taught us a few tricks, and generally calmed things down.
It’s also worth remembering that there are many different ways of measuring what’s “typical”. For instance, suppose that a person has a disease. The disease itself has a fairly predictable progression, but there’s a new treatment that works occasionally. So the doctor might tell you “Well, you probably only have about three months, but this treatment has a 30% chance of curing you”. So, you opt for the treatment. If you make it to four months, that probably means that you were one of the lucky ones, and the treatment worked. If you make it to a year, then you were almost certainly one of the lucky ones. Ten years later, you’re still one of the lucky ones: Making it to ten years, in that case, was no more remarkable than making it to one year. And the odds you beat weren’t even all that long. But it still makes it sound like that doctor got it way wrong, even if he said the exact same thing to the next two patients with that condition and they both died 91 days later.
Well, yeah.
The only time I’ve known my sister-the-hospice-doctor to make even a somewhat firm prediction regarding life expectancy was when my mom started agonal breathing. At which point she said if you want to be there when mom dies you need to come into the bedroom now.
It’s my understanding that certain signs indicate very near death, hours or minutes away, but you’re not going to get those six months out. I’ve talked to my sister about the topic both when mom was dying and when dad was. There is no exact way to predict a person’s death.
And yeah, as Qadgop said, a lot of the time what the doctor says and what the patient hears are two different things.
(Just as a point of interest - people aren’t supposed to become my sister’s patient until they have only six months left. Quite a few die in hours or days. The record survivor currently at her hospice is five years… which is totally OK, good for them.)
And that’s another thing… doctors are human and some of them have a real fear of death and/or failure.
Second-to-last hospitalization of mom, which when she started expressing a wish to go home and stay there, even if it meant dying there, we had one doc who was actually hostile to the notion of hospice, accusing us of giving up on and killing mom. At which point every family member in the room skewered him with a withering glance of disdain and Dr. Sister pulled him out of the room and read him the riot act in the hallway. Not sure exactly what transpired after that, but we never had to deal with him again.
Sometimes. My Dad was told by his doctor and the doctor got it within 2 weeks; Dad never told us though. He and his doctor had been together in their respective roles for some time and Doc wanted Dad to have the time to “finish things up”. When my MIL was going downhill and had progressed to hospice care, we were given time-frames along the way and they were pretty much correct. And helped us a lot understand and prepare ourselves. But I have a feeling hospice itself is very different from Dad’s 6 months out thing and informed guesses are a lot more common there.
There’s a lot of research done on how to predict how long a person with cancer is likely to live. A lot of people study a wide variety of factors related to age, disease stage, general physical condition, and so forth in order to come up with prognostic factors. In addition to using these predictions to help patients plan their lives they use them to decide on treatment. If it’s pretty clear the patient has practically no chance of living for more than a few months, it’s not a good idea to destroy that person’s quality of life by offering intensive chemotherapy or some kind of radical surgery.