My aunt has stage IV lung cancer and schizophrenia. She has estimated a couple months to maximum a year left. She is continually saying she cant breath and her back hurts, but her O2 stays at around 95% and she can talk clearly without oxygen. She was not prescribed home oxygen. She has been doing radiation she does miss her apt. occasionally. She did Chemo for a while but she was not committed to going, and it caused her a lot of distress, She is mobile, and able to take care of herself (shower, change, uses the bathroom), but not able to communicate with health care staff effectively. She is now staying with her adult children, who work. She gets anxious and upset when she is home alone.
The problem is she keeps asking to be taken to the ER. She says the ER can take care of her and give her the pain medication and oxygen that she needs. She has been taken before and discharged the next day. Her children are young adults, low 20's, working, and going to college and utterly exhausted. She wants to stay at the hospital, and says that she needs more care than our family can provide. My main question is; is there a long term care facility that can accommodate a patient with these types of problems? We live in Clemson SC and desperately need resources.
We considered a home health nurse, but she can get upset and occasionally cusses people out. She's never violent, but she will get upset over something that never happened. We are unsure if a home health nurse could handle that. We also wondered about hospice care. She is fairly self sufficient but she is in constant pain, she says 'I can't live like this anymore', and has began sleeping more and having nausea and vomiting. She is also very anxious which contributes a lot to the situation and very adamant that she struggles breathing. She has insurance but we aren't sure if insurance would cover something like this or if there are resources for such a unique case?
Thank you for your time!
Reply # - March 5, 2015, 11:52 AM
I'm so sorry for this awful
I'm so sorry for this awful situation your aunt is in. I know how difficult it is to care for someone with schizophrenia and I couldn't imagine adding lung cancer on top of that. I'm don't believe we have a faculty who has an answer though I'll contact one of our palliative care specialists to comment on ideas.
A social worker with the cancer center or mental health center in her area may be better able to suggest something for your aunt. If she has pain it can most likely be helped with pain meds and or radiation.
I hope your aunt finds comfort soon and the family is able to help.
All best,
Janine
Reply # - March 7, 2015, 09:55 AM
Dr. Ramchandran wasn't able
Dr. Ramchandran wasn't able to access her forum account and wanted me to sent this to you. She said,
"This sounds incredibly difficult and I can image your family must be struggling. Without knowing all of the details I would consider a home hospice group. There are a few with open access options that will allow your aunt to continue therapy that might help her quality of life. Additionally I would consider a skilled nursing facility with hospice support at the nursing facility.
"Finally it might make sense to sit as a family and discuss your aunt's goals. Not only now but who she is as a person, and how she would wnat to be treated at a time like this. If her goal is quality of life and that trumps longevity (which it sounds like it might) a full hospice program might be appropriate.
"My thoughts are with you."
Reply # - March 7, 2015, 10:00 PM
Hwaddel1,
Hwaddel1,
I'm sorry to hear about such a difficult situation for your aunt and for you. I agree with Dr. Ramchandran on accessing hospice as a resource. They would have experience with patients who have cancer and schizophrenia at the same time. They may know of caregiving resources for patients with psychiatric illness, ie home care nurses with psychiatric expertise, as well as if there are any nursing facilities that specialize in psychiatry (they are less common, so this may be outside of Clemson). Patients with schizophrenia as well as other psychiatric disorders can need adjustments in their psychiatric treatment with the significant stress of cancer; her psychiatrist or a psycho-oncologist (psychiatrist who specializes in patients with cancer) could help her with her coping.
Take good care. It is heartening to read about the support she has from you and her family.
Dr. Harman
(Palliative Care)