Humans have an incredible ability to adjust and change to our surroundings. Something catastrophic happens and somehow we go on. We begin to change our lifestyle and twenty year old routines within 24 hours. This happens when a crisis happens to those we love most. An accident, an illness, or during the end stages of our loved one’s disease we leave our old life and begin a new one. Patients of mine going through these crises call me from a local hospital telling me they are in the emergency room with their loved one due to a fever, or dehydration. I feel panic and yet they are calm; this is their new normal.

We would all like to help our friends going through this new normal but saying things such as “It will get better, or I’m sure it’s nothing” don’t really help. This won’t get better, and it really is something. I thought it may be helpful to get an idea from a patient’s point of view that is dying from end stage cancer. This patient is a sister of one of my closest friends. There is an eloquent poignancy in her point of view as she has very limited time with us. However, if we can understand the things that are important to our loved one as they are in the process of dying, we may be able to connect and love them better while they are still with us.

Tips to living with end stage cancer- Anne

1.     Re-live wonderful moments. If you are alone, go on a mental “remembrance trip.” With a partner, remember the details of the event, how it felt, and thank your partner for the wonderful times shared.

2.     Develop an appreciation for “cancer humor.” The fears and frustrations of treatment and impending death can generate absurd and darkly funny situations and dilemmas.

3.     Savor the details of “dailiness.” As it becomes more comfortable to be at home than anywhere else, develop an interest and appreciation for one’s surroundings. Rearrange the pots on the sun porch so their colors and designs are easier to see and enjoy. Bird feeders close to windows bring hours of beauty.

4.     Be open to new relationships. Seeing the same person during a series of radiation treatments is an opportunity for astonishingly honest conversations and a special intimacy. End Stagers are entitled to say to one another “I understand.”

5.     Express rage or indignation at some social or personal injustice. If one discovers that cancer folks, as well as yourself, are routinely ignored by medical personnel when seeking answers to end of life questions, raise hell!

6.     Resist the urge to have the last word with loved ones. It may be your last and think about what kind of memory this will leave with your loved one.

7.     Relish the good days when physical/spiritual energy is high. Sometimes one can actually forget that they are at the end stage of everything. Make plans for your spring or summer garden. Plant daffodils. Maybe you won’t be around to enjoy them, but someone will.

8.     Accept the “weeps,” the tears that inevitably flow when energy is low and the future seems bleak. Cultivate the art of self distraction. A long nap or immersion in a novel or old movie usually helps. Avoid dwelling on the details of impending death. There’s no point, it won’t change anything.

9.     Stay organized. On good days, make lists of things you want to do no matter how trivial. Try to do them. It helps keep you focused on the present.

10.  We share the human condition. All of us are potentially “end stagers.” The only difference is we’ve been alerted to our impending demise. As you savor the remaining days, give death no more place than it deserves (which isn’t much since it will ultimately get its way in a time and place of its choosing). It is good to keep in mind the question, “What if I don’t die?” Live accordingly.

Anne didn’t mention in her list the importance of faith or one’s spiritual beliefs. This will be very important to your loved ones’ “new normal.” If your loved one is dying or is chronically ill, talk to them about their faith. Stay open to what they believe and try to support and respect their beliefs.