How do I know if it's the right time for my father with lung cancer to enter hospice?

A fellow caregiver asked...

My father is in prison so I have limited info about the type of cancer. it all confuses him but no one can talk with me about it but him. He was diagnosed in Nov with lung cancer (dont know the type) he didnt get his first treatment untill Jan. he said he was getting chemo treatment once every 3 weeks and they told him the 1st of march it wasnt working he needed to go to hospice. I dont know but I really dont feel like this was long enough to tell if it would work or not. What should I do? was this long enought to tell if it was going to work? he can still walk around on his own and things...

Expert Answer

Bonnie Bajorek Daneker is author and creator of the The Compassionate Caregiver's Series, which includes "The Compassionate Caregiver's Guide to Caring for Someone with Cancer," "The Journey of Grief," "Handbook on Hospice and Palliative Care," and other titles on cancer diagnosis and end of life. She speaks regularly at cancer research and support functions, including PANCAN and Cancer Survivor's Network. She is a former member of the Executive Committee of the CSN at St. Joseph's Hospital of Atlanta and the Georgia Chapter of the Lymphoma Research Foundation.

It's tough to know what the right course of action is when you have limited information, but let's talk about what you do know. If he was diagnosed in November, that means that they have a baseline of what his illness was then. For example, they will have scans and other images that will show where and what size the cancer is. Also, if he's getting chemo every three weeks, he may have already had five or six rounds. It's customary for healthcare professionals to do periodic checkups to see the effects of the chemotherapy. They often repeat tests used in diagnosis to see what has changed -- usually size and spread. Some cancers do not respond to chemotherapy. It sounds like your father's case was not only aggressive but also later stage. If he has an aggressive cancer, they will be able to see right away if the chemo is imparing the cancer's growth.

If they're prescribing hospice now, it's likely because the cancer has continued to grow and could be spreading or impairing other organs. As you know, they suggest this program of care to comfort when the prognosis is 6 months or less to live. He may still be able to walk around and do things for himself for a while, but it's hard to say how long he will be able to do that. With labored breathing, the rest of him will have less energy and ability, as oxygen is needed through the system.

I would suggest that you ask to be involved in his hospice care. If he lets you, ask specifically about what they can help him with and what his path is likely to be as the cancer progresses. If he doesn't want you to be involved or continues to give you limited information, continue to listen and visit as much as you can, but understand you cannot help him more than that. Good luck to you.