How can we support my brother-in-law and his family through the last stages of cancer?
My brother in law has Stage 4 cancer with mets to liver and brain. His time is limited and he has small children; 8 and 7. How can the extended family help everyone involved?
Meals are being provided 2/3 days a week with a freezer full of meals.
As I live one hour away I feel some disconnect with not being able to be there on a regular basis. I guess I feel guilty that I am not there to support my sister more.
What do we do and how do we cope?
Expert Answer
I know this is a trying time for you, and when you're attempting to involve the rest of the family in his care, it can be very frustrating. Try not to feel guilty; you're involved and want to help, however extensive that may be. It's a good start.
What works for many is to develop a "Care Plan" and a "Care Team." Basically, it's helpful to try to be organized, writing down what needs to be done, then prioritizing that. Next, spend some time identifying who can help realistically, then match the two. This sounds simple but it can be very emotional. There are three areas to plan within: Medical Care (is he in a hospice program?), Personal Care and Hygiene (does he need help bathing and dressing?), and Family Interaction (who does he want to see, when and why?).
You should put together a draft of this plan and the people that can help and talk to her. You can add and change this as his needs change. Your sister should have a handle on this, but remember, she's not been through this before and she's also very emotionally vested. Let her edit, assigning herself for some tasks, and YOU taking on others. She needs to know she can count on you otherwise she won't give up those tasks, and no doubt she needs to rest. Her children need her too. Speaking of children, involve them as well - playing games, looking at pictures etc. can be a good distraction for everyone. Plus, it will leave some happy memories.
Another area I would suggest you try to help is to have a very private conversation with your brother-in-law about end of life and unresolved issues. Man to man, ask him directly about what he would like to accomplish with his limited time. I've heard a few patients with young children ask to record a video for them. This is a touching gift they can have forever -- seeing and hearing their dad's love for them and what he would want them to know. You could do that with a camera or phone.
There are more things you could do: are there conflicts he'd like to resolve? Are there letters he'd like to write, or does he want to give some precious belongings to others? Use your physical strength to help both him and your sister. Find out about respite programs for her, so a nurse can come in and help out. Can you can come once or twice a month? In these last months it would be critical to the whole family. As a strong male model, you can give the children strength as they see their dad decline.
You're not powerless in this, and the journey together doesn't have to be heartbreaking. You have the chance to create some loving memories and be of help to your sister in different ways. Be sure you have an outlet too, talking to clergy or a bereavement counselor or friends just to get this out. Or, write back to me. I'm happy to listen. Good luck to you.