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Preparing for sudden deterioration in someone with a terminal illness

Key points about acute crisis

Acute crisis refers to any life-threatening situation that could occur suddenly and would need urgent medical attention.
An acute crisis can occur if you you have a terminal illness, (eg, cancer) and something suddenly changes to make you very unwell..
These are uncommon but can be frightening for you or your family/whānau.
Thinking and planning beforehand about what could happen and what needs to be done if an acute crisis occurs can make all the difference.
You or your carers may want to work with your main health care provider to write an emergency letter and instructions to be passed on to other health professionals involved in your care.

Adult daughter and mother touch foreheads supporting one another

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Some of the symptoms of an acute crisis include:

extreme pain
bleeding
dizziness
fits
sudden chest pain
sudden shortness of breath
sudden abdominal pain
weakness of your arms or legs
feeling really unwell
disorientation (confusion).

If you have planned what to do beforehand then you will know who to call. Otherwise it may be appropriate to call the local hospice if you are under their service, or call an ambulance or go straight to hospital.

Before treatment is given, your doctor or ambulance officer may ask you some questions about your wishes, whether you want to be admitted to the hospital or receive medication, and whether you have any advance care plan. Read more about advance care planning.

You may be prescribed medication through your vein (intravenous), the fatty tissue layer under your skin (subcutaneous) or under your tongue (sublingual) to address the immediate situation. Common medications that may be given to you include:

pain relief medications
medications to ease your breathing
sedating medications.

If you are not already in hospital, you may be admitted to hospital and receive medication.

It can be scary if you experience any of the conditions above. Talk through your feelings with your family/whānau members or health professionals taking care of you. You may want to write an emergency letter and instructions [DOCX, 24 KB] to be passed on to other health professionals involved in your care. You can do this with help from your whānau and primary healthcare provider.

Below are some support services and information for people affected by cancer and their family/whānau:

Emotions and cancer(external link) Cancer Society of NZ
How we can help(external link) Cancer Society of NZ
NZ cancer services - find a hospital/service near you(external link) Healthpoint, NZ
More cancer support groups