How do doctors determine the amount of time a terminally ill patient has left?
In: 330
Best guess.
Then, if the patient is staying in the hospital or in a palliative care unit, until they pass, it’s laid on the nurses.
And the nurses get asked multiple times a day by the family how much longer. And all we can do is guess based upon the signs we see the patient exhibiting.
The worst one I was off on was 3 days. At the last hospital my coworkers were off by -1 day. Literally had a dead patient turning purple and let rhe family visit. The machine he was on for breathing was giving him a false pulse and chest rise. As soon as he became my patient I removed it and it all stopped in seconds. The hospital still uses it as an example to assess your patients not just casually glance at them.
But it gets easier as the patient gets nearer to death. There are some wild cards which are difficult to factor. Heart attack usually.
We’ve had patients brought up that died within minutes of getting on the floor. One must have been dying and rotting for a long time prior to her last breath. Another with liver failure died as his wife was unpacking his bags.
Doctors absolutely hate being near death. Especially covid deaths. So nurses are the ones there with the morphine and other drugs to ease things. We’re the ones with the guilty conscience following doctors orders. Well, if we feel guilt. Sometimes it’s time to go.
-Frankie’s husband
I thought I heard that in Australia they’ve more or less abandoned the practice of telling some patients how much time they think they’ve got, especially with cancer, because so many things can vary the outcome, and telling people they only have 6 months often takes the will to fight out of people, or becomes a self-serving prophecy.
So they only tell you if it’s a short time left and you need to get affairs in order and things like that.
Someone can correct or clarify for me if I’m remembering correctly or not.
Just want to mention that sometimes they’re wrong. A friend diagnosed with aggressive cancer was told they had 6 months to live, at most. Its been seven years now, the cancer is no longer detectable.
Just been through this in last few months.
Dad (85 y/o) was diagnosed with brain tumor 13th Sept 2022. Doctor gave 3 options:
1) Do nothing and go within 3 months
2) Have Radio/Chemo therapy and maybe get 6 months
3) Brain Op + Radio/Chemo and maybe get 9 months
Dad chose option 1 and he went within 6 weeks (28th Nov ’22). And this is how it was explained to me:
Over the years they have seen patients of all ages with brain tumors of various sizes and recorded the results of how long they took to pass.
Then they take an average time for an age of X with a tumor size of X. It pretty accurate.
Mostly experience and statistics
Given the patients age, symptoms, sickness and state, doctors can give you an informed guess
In my experience, they often can’t very accurately. They have data about how long the average patient with X life limiting / terminal illness will live, and from experience they can look at your current symptoms and give a rough idea. But often they won’t commit to a timeline at all.
My mum died from cancer 7 years ago. She lived about 18 months from diagnosis. She was initially diagnosed with ovarian cancer which couldn’t all be removed – they told her it was not curable but couldn’t give a timeline because it depended on response to treatment. After treatment she went into remission for a while, but then it started growing again, almost 1 year after diagnosis.
She went to be screened for a study and they found the ovarian cancer was secondary (very unusual) to a rare form of stomach cancer which usually has a prognosis of around 6 months. It was past the point of surgery so she had more chemo.
She was doing really well until the cancer obstructed her bowel and she couldn’t eat because she couldn’t pass waste. At that point they knew roughly how long she could have be her we can only survive for so long without food. And even then, it was only about 48 hours before she died that they could say it would happen within the next few days.
Cancer is really nothing like what you see on TV, and giving very specific timeframes is very unusual and often incorrect. Often times are given based on organs starting to fail or bodily functions no longer working.
Generally speaking, a doctor does not “give someone 6 months to live”. Setting a date can make a doctor liable to lawsuits. A doctor can say a person is in end stage cancer, which is spreading very quickly, and people with end stage typically do not make it a year.
When my mother was dying it was all euphemisms and vague wording, even when it was imminent. I asked the doctor straight out, and he told me that there are many factors and it would be a violation of his ethics to guess how long she had left. He could only tell people what typically happens.
IIRC: It used to be based off of data sets. X number of people with Y problem lived an average of Z. With the advancement of science and technology the survivability of a lot of things has changed.
Now though? It depends on how good your insurance is and how much money you have.
When a patient is terminally ill, it can be really hard to predict exactly how much time they have left. But there are a few things that doctors can do to try and get an idea. They’ll look at the patient’s medical history and current condition, run some tests, talk to other doctors, and have conversations with the patient and their family. All of this information helps them make an educated guess about how long the patient might have. It’s important to remember that every patient is different, so these estimates aren’t always 100% accurate.
And don’t forget, it depends on how many people pray for the terminally ill patient and their family and how often and how hard they pray. That can certainly change the amount of time the patient has left, and, if the doctors aren’t aware of all this praying business (or if they’re thinking a lot of praying is going on and it’s actually not), then they could give a very wrong estimate.
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