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My mom won't finish her radiation, and she's depressed. What can I do?

Mich4567 asked...

My Mom was diagnosed with Squamous Cell Cancer of the back of the tongue. She finished 22 out of 35 radiation treatments along with chemo. Now she has a hard time breathing. She refuses any more treatments. She lives with me and she wants to die. She is very depressed and does not want to start eating by mouth since she has a PEG tube. She takes Xanaz, Elavil and Lexapro. She is 80 and she has always been depressed my whole life and she never wanted to get herself help. She just does not have any interest in anything and sits and stares at the floor when she is not in bed. She is a full time patient with her meds, tube feedings, etc. and I am afraid to leave her alone. I wish I could get her some help on her depression. I know she has been through hell since January and I love her so much. This is breaking my heart that she has no will to live. What can I do? Would she be better in a rehab so they can assist her in starting to eat by mouth and helping her with her depression?

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.

From your email, it seems like you are trying valiantly to help her, and she is lucky to have your care. However, she has some major difficulties, and the first piece of advice I would give you is to not try to handle this by yourself. Is she able (strong enough) to move to a rehab facility? They may be able to help. In the meantime, there are some other questions "“ tough ones "“ you need to think about now:

  • From your perspective, if she has been depressed her whole life, is there something happening now that would change that (the medicines or living with you?). Eighty years is a long time, and changing a lifelong pattern is a difficult task. You have clearly involved a trained professional if she's on these medicines. When was the last time they evaluated what she is taking? If the doses are appropriate, does she regularly take her medicines? Will she see a psychiatrist, social worker for the oncology practice, or another professional that can give you their opinion of her longer-term care needs?

  • Her treatment schedule "“ even for a 20 year old "“ is substantial. It's understandable that she would refuse more for a while, and even refuse real food. She may not have the energy or the ability to chew and swallow. Is there any danger in her continuing to use the PEG?

  • Have you talked to her about honoring her wishes? I know this is difficult, but maybe it's time you asked her about end of life care. It seems she is in misery: beyond the depression you mention loss of appetite and difficulty breathing; there is likely pain and weakness. Her quality of life seems low.

She's your mother, she's been with you a long time, and it's hard to think about life without her, I know -- but she may not improve. What are ways that you could continue caring for her to give her comfort and love without trying to heal her? If you need help understanding what this means, look into this website: www.cancer.gov/cancertopics/factsheet/Support/home-care. If you help her this way, you're not failing as her caregiver.

Also, don't forget: You'll be a better caregiver if you can take a breather and recharge your own batteries for a while. It's important that you feel secure enough to be able to leave the house and continue on your life as well.