Since you want to know what the last weeks or months are like, I will share with you what I have seen in the people I have known that have died. Like Colleen Young said, it seems like each person is different but I sure would have appreciated honest information when my mother was dying.

I had a friend that voluntarily went in hospice at home. In her case, she just gradually ended up in a wheel chair and then was obviously very drugged up for the last few weeks until she died. Based upon what happened with my mother, I think the drugged up option is the way to go.

My mother got ascites and had a procedure at a hospital that released all kinds of infection into her system and that is what killed her. She was totally mentally sharp at all times until she died. She described that she was suffering a lot after the infections were released (I use the plural because cultures identified at least two types of bacteria and two types of fungi). I do not think that my mother was administered enough morphine to make her comfortable and we had no one there to help. She was conscious that she could no longer breathe and there was nothing we could do. If at all possible, I would try to avoid that set of circumstances. She was in hospice at home but the nurse left and we were on our own.

My grandfather elected to have hospice at home and he was given enough medicine that he appeared to be totally asleep and unconscious. I would think that would be more pleasant. He was not a cancer patient, so I don't know if that is different.

You asked about palliative care, though, and not hospice. My mother had been enrolled in palliative care up until the last 24 hours of her life. The palliative care nurse that came to the house was very helpful, much like a nurse in a doctor's office. In each case, whether it be the palliative nurse or the hospice nurse, they claim to do "everything." I am not sure what they consider everything, but we really would only see them for a few minutes and the rest was up to us. I did think the services provided through the palliative care system were helpful. They did provide other people that would stop in for a brief visit if you wished, like social workers for example.

My father died in a hospital. He was not feeling well and got admitted. I no longer remember why. He was able to visit and so forth and died during the night. I guess what I am getting at here is that the cancer patients I have known seem to all have been able to talk and visit and so forth right until the end of their lives. From what I have seen, which is very limited, I still do not know the best way to go. It seems to me, from what I have seen and also what I have listened to on Doctor Radio, that having enough medication at the very end of life is very important. If you start to have respiratory failure or are experiencing tremendous suffering, it seems to me that having enough medicine to be unconscious would be the best option. I would think you would need medical professionals to help you know when that is happening. In the three cancer patients I have been close to, I guess the part that surprised me was how much they could be engaged in life with such horrible cancer. My mom got palliative chemo and that gave us an additional eight months that were a real blessing. I have often wondered what I could have done to reduce the suffering in the last month of her life.

I have wondered if it is better to die in a hospital hospice unit so you have medical professionals there to be sure you are administered enough morphine (or whatever medicine you are administered). I have heard the doctors on doctor radio advise that some of the really bad things that have been described happened because the patient did not have enough medicine. I do not like home hospice because it seemed to put the burden on me/us of being the health care professional and I felt totally unequipped to do that. On the other hand, most people seem to want to die at home.

I am sorry to write such a rambling response. Some of this is still really painful for me to think about. I am sorry you are going through this. God bless you and I will pray for you.