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Depression and terminal cancer: Won't anyone talk about it? 
Started by Diana2012
16 Jul 2012, 2:56 PM

Hi,
I am new to this forum and I am so glad I found it.  My mother-in-law has colon cancer that has spread to her liver and lungs.  About 2 months ago her doctor told her that chemo is no longer working for her and there is nothing else left to help her.  Since then my MIL has become depressed and has gotten worse.  She is experieincing all the signs of depression and we are not sure what to do about it.  She sleeps most of day, doesn't participate in family events, stays home all day every day, she's not interested in conversation , it's as if she's in her own world.

We are not sure what to do.  Has anyone experieinced this? 
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Reply by Cath1
16 Jul 2012, 4:38 PM

Hi Diana2012:

Welcome to our Virtual Hospice community!:-) I'm sorry to hear of your mother-in-law's illness but I am also glad that you found us and I hope we will be able to help you feel supported in your situation. Your worries for your mother-in-law regarding her feelings of depression are valid and I understand and admire your desire to help her. She and your husband are both fortunate that you are actively resourcing ways to make a difference for her!

I am posting a link to another thread as there are many similarities I think in your mother-in-law's situation and the person, Charneypam, who started that thread because she was worried about her aunt and how she was coping.  I am hoping you will find some guidance when reading Charneypam's posts and the responses to her.     http://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Support/Support/Discussion+Forums/Just+Want+to+Talk/2011_12_27_16_09_28_Decision+to+end+treatment_+Stage+iv+bowel+cancer.aspx

I'm not sure about posting links so maybe the moderator can fix it for me if it doesn't turn up properly on this page. 

I think it's pretty natural to feel completely overwhelmed and despairing as does your MIL when one receives such terrible news about having cancer. It is a huge jolt and it makes a deep emotional impact, but there are ways to help people cope and the first stop is with your MIL's doctor or oncologist to discuss and discover what can be done. 

In the meantime, I suggest that your husband and you just keep gently encouraging your MIL to accept invitations to visit and to talk about her feelings. If she is unwilling or unable to discuss her feelings with either of you, perhaps she has a close friend with whom she may feel more comfortable sharing her feelings and fears.

I know I would be sensitive to my children if I were in your MIL's position and all my instincts would be to protect them so it would be hard to talk openly with them as I would not want to frighten them. Ironically though when we choose to internalize our feelings while hoping to shield our loved ones from worry that approach only increases their concern and keeps us isolated in our pain.

I look forward to hearing what others have to say to you Dianne2012, and I hope most of all you will have more hope today by reaching out to us than you had when carrying this worry alone. You are not alone. We are listening and we all care.

With affection - hugs - xo   
Cath1
   
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Reply by Diana2012
16 Jul 2012, 7:40 PM

Hi Cath1,

Thank you for your advice.  My MIL is not willing to talk to her oncologist or doctor about her depression.  I don't even think she acknowledges the fact that she is depressed.  Perhaps I should speak with her doctor myself?

She has a close friend, but she will not open up to her about her illness.  My MIL has hidden her sickness from extended family and friends for the past 2 years, she didn't want to be felt sorry for and she didn't want people seeing her as she lost her hair.The extended family knew she had cancer, but they didn't know the severity of it and how fast it's progressing. Extended family now knows about the situation b/c we have opened up to them about what is going on with her and the times that they have seen my MIL that have noticed that she looks 'sick' and have asked us about her.

I understand that as a mother she may not want to talk about her feelings, but I do think she will benefit from talking to someone but she is just not willing to do so.


I read the link that you posted, but it doesn't seem to answer my questions.  I am wondering what to do, let her be or force her to get out of her depression.....
  
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Reply by Cath1
16 Jul 2012, 8:51 PM

Hi Diana2012:

I'm replying to you from my phone but it is not easy to write on such a tiny keypad!:-) Tonight I will write to you with a more fitting response, but in the meantime please know that you can never force someone out of depression or force them to cooperate with your suggestions no matter how  well intended.

Until we talk again, hang in there

With affection -hugs- xo
Cath1 
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Reply by Cath1
17 Jul 2012, 12:18 AM

Hi Diana2012:

I'm home now and on my regular computer - so much easier to see and type on it!:-)

The reason I recommended the other thread is because Charneypam's aunt was also very private and she was not interested in speaking with her doctor or her family about her illness or prognosis and she had decided she simply wanted to let nature take its course. Charneypam wanted advice on intervening on behalf of her aunt directly with her aunt's doctor because she too was worried about her depression and isolation.

Personally, I don't think it's always a good idea to go over a loved one's head or behind their back IF the person is mentally capable of making a decision and that decision is that they don't want anyone to speak to their doctor for them. I think as hard as it is to watch someone suffer or to perceive them as suffering, we don't have the right to go against their express wishes. Your MIL may feel disrespected or betrayed if you were to consult her doctor without her knowledge or permission.

However, having said all that, if you are worried about your MIL's state of mind and the possibility that she is clinically depressed, you have no choice really but to alert her doctor. I think if her doctor was informed he would be able to help and I would suggest it is worth a try. S/he could bring up the subject with her and ask her how she is coping and perhaps suggest to her some medication that could help or counselling she could access. Of course the guidance she would receive would depend on how honest and forthright your MIL is with her doctor. People sometimes hide their fears and symptoms from doctors.

So Diana2012, I see no harm in you and/or your husband contacting your MIL's doctor to express your concerns, but that is only my opinion and I'm not a healthcare professional. Should you decide to call your MIL's doctor, be prepared that most doctors will not under any circumstance discuss their patient with others, even close family, without permission of the patient, but many doctors have no objection to receiving input and in fact may welcome additional information about their patient from family as long as the family knows that the doctor may not be able to comment directly about their patient to them.

Perhaps now is the perfect opportunity to discuss with your husband, and maybe soon at the right moment with your MIL, her wishes for end of life.  You may want to discuss getting a Power of Attorney document for her personal care which includes her healthcare and which will empower the person(s) she chooses to make decisions for her in the event that she cannot.

Do you know what she would want as far as what treatments or medical interventions she would want and accept - or not - should she be unable to communicate her wishes down the road? If not, it would be best to think of these things now and gently raise these questions with your MIL. If she is unwilling to speak to you about these things I don't know what more you can do but accept that she is being very private about everything for her own personal reasons. She may just need a little more time to accept her situation. You can very gently keep trying to encourage her to open up and talk with you but she may not welcome your concern and she might just clam up. It is not anyone's fault if she does, as I imagine she feels her world is turned upside down right now and it must be an enormous struggle to make sense of what is happening and to hold on to hope. I feel for her and for you and your family as I imagine you all feel quite helpless.

Your husband and you know your MIL best and I think you have to walk gingerly around all sensitive topics while she is adjusting to the news the doctor delivered when s/he said that there is nothing more to be done for her. So sad that she is surrounded by loving family and a close friend who want to help her, but the way she is reacting may be in her mind her best way to cope. Ultimately, if she is lucid, how she accepts help or opts to decline it is her choice.

Perhaps if you have children, you could ask your MIL to work with them on a making a memory box as a summer project? If you don't have kids, is this something your husband and you could do with her? Sometimes, looking back at old photos and mementoes has a way of bringing to the surface many emotions and it may open the door of opportunity to deeper discussions. Let me know what you think and how things go. I hope somehow you will be able to draw your MIL out of her shell and into your circle of love and support.

With affection -hugs- xo
Cath1  


    
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Reply by Diana2012
17 Jul 2012, 1:28 PM

Hi Cath1,

Thanks again for all your advice. My MIL was admitted to the hospital last night.  Her swelling and bloating (due to her cancerous liver) was too much for her to handle last night, she was so uncomfrotable.  She is still there as I write this.  I am worried that they will keep her there and she will never come out Frown

   I understand how my MIL may feel betrayed if I went behind her back and spoke to her doctor about her depression, it's only normal to feel that way.  There is no way that my MIL would open up to a doctor about the way she feels.  She has a daughter and she does not talk her about her feelings either.  Her daughter is in denial so doesn't face the facts of her mother's sickness.


There is no way that I can bring up my  MIL's end of life wishes with the family.  I don't feel like it is my place to do so and i feel that we start talking about that we are giving up hope.  My MIL has 2 grandchildren, but making a memory box will make her feel worse.   


I found a hospital in NY(we live in Toronto) that will review my MIL's file without having to see her.  I told my husband about this, but he didn't seem too interested.  He wasn't sure if he can handle anymore bad news and he doesn't think that the States has anything different to offer her.  I think it's worth a shot.  My husband is also not sure whether or not his mom should be put on any medication b/c she will more than likely feel sick on the meds.  He wants her to enjoy her life, but right now she isn't enjoying her life, she's depressed and feels so heavey b/c of the bloating that she can't even walk on her own.
 
You're right, I guess I can't force her to go places or to visit.  All I can do is encourage her to do stuff and if she's not up for it I guess I have to let her be.  


This is all just so sad.


Thanks again!


Diana2012     
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Reply by Cath1
17 Jul 2012, 1:50 PM

Hi Diana2012:

I'm so sorry that you MIL had to be admitted to the hospital and I understand how upsetting it is for her, for you and her family. My ex's family sounds a little like your husband's - a lot of denial and very little open display of emotion and heaven forbid, no open communication. It is very hard to be among people who respond as they do if you're the type who wants to do or say something to help, but alas you have no control over the situation and you certainly cannot change the family dynamics on your own.

This morning I am thinking of you Diana2012, and I feel your sadness. You are right it is a very sad situation. It will be hard for you to not do anything when you identify so many ways you could help, but perhaps you MIL is consigned to the fact that she is dying and she will keep her feelings about it to herself. I hope you have your own family and friends to lean on for support! 

Write any time you wish as your MIL's situation progresses. We're here to listen. You and your husband and your MIL and her family will remain in our thoughts and prayers.

With affection -hugs -xo
Cath1  
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Reply by Diana2012
17 Jul 2012, 6:28 PM

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Reply by Cath1
17 Jul 2012, 6:33 PM

Hi Diana2012:

I see you are trying to post. It's annoying but sometimes the system times out and you may have lost your message. To avoid this from happening again copy your text prior to pressing submit and if for any reason your message doesn't post, you can paste it in a new message and post it again.

I hope this helps!:-)  

Cath1   
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Reply by moderator | modératrice
20 Jul 2012, 12:18 AM

Hi Diana,

I'm sorry that you lost your post. Please feel free to contact me if you are still having technical problems. colleen@virtualhospice.ca

How is your mother-in-law doing? Did she return home or stay in the hospital?
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