Care at the Very End-of-Life: Dying Cancer Patients and Their Chosen Family's Needs

被引:34
作者
Clark, Katherine [1 ,2 ]
机构
[1] Royal North Shore Hosp, Canc & Palliat Care Network Northern Sydney Local, Pacific Highway, St Leonards, NSW 2065, Australia
[2] Univ Newcastle, Sch Med & Publ Hlth, Newcastle, NSW 2981, Australia
关键词
care of the dying; symptom control; care needs; PALLIATIVE CARE; GOOD DEATH; PEOPLE; IMPACT; PAIN; COMMUNICATION; MANAGEMENT; SYMPTOMS; DISTRESS; DELIRIUM;
D O I
10.3390/cancers9020011
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The majority of cancer deaths in countries such as Australia are predictable and most likely to occur in hospital. Despite this, hospitals remain challenged by providing the best care for this fragile cohort, often believing that care with palliative intent at the very end-of-life is not the best approach to care. Given the importance that dying patients place on excellent symptom control, failing to provide good end-of-life care is likely to be contrary to the wishes of the imminently dying patient and their family. This becomes even more significant when the impact of care on the bereavement outcomes of families is considered. Given the rising numbers of predicable hospital deaths, an urgent need to address this exists, requiring health professionals to be cognisant of specific care domains already identified as significant for both patients and those closest to them in knowledge, care and affection. This non-systematic review's aims are to summarise the symptoms most feared by people imminently facing death which is defined as the terminal phase of life, where death is imminent and likely to occur within hours to days, or very occasionally, weeks. Further, this paper will explore the incidence and management of problems that may affect the dying person which are most feared by their family. The final section of this work includes a brief discussion of the most significant issues that require attention.
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页数:10
相关论文
共 54 条
[1]   Efficacy of Oral Risperidone, Haloperidol, or Placebo for Symptoms of Delirium Among Patients in Palliative Care A Randomized Clinical Trial [J].
Agar, Meera R. ;
Lawlor, Peter G. ;
Quinn, Stephen ;
Draper, Brian ;
Caplan, Gideon A. ;
Rowett, Debra ;
Sanderson, Christine ;
Hardy, Janet ;
Le, Brian ;
Eckermann, Simon ;
McCaffrey, Nicola ;
Devilee, Linda ;
Fazekas, Belinda ;
Hill, Mark ;
Currow, David C. .
JAMA INTERNAL MEDICINE, 2017, 177 (01) :34-42
[2]  
[Anonymous], BMJ SUPPORT PALLIAT
[3]  
Australian Commission on Safety and Quality in Health Care, 2013, SAF QUAL END LIF CAR
[4]   Opioids for the palliation of refractory breathlessness in adults with advanced disease and terminal illness [J].
Barnes, Hayley ;
McDonald, Julie ;
Smallwood, Natasha ;
Manser, Renee .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2016, (03)
[5]   Screening, evaluation, and management of cancer-related fatigue: Ready for implementation to practice? [J].
Berger, Ann M. ;
Mitchell, Sandra A. ;
Jacobsen, Paul B. ;
Pirl, William F. .
CA-A CANCER JOURNAL FOR CLINICIANS, 2015, 65 (03) :190-211
[6]  
Bernacki R.E., 2014, JAMA INTERN MED, V74, P1994
[7]   Cancer pain [J].
Bruera, E ;
Kim, HN .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 290 (18) :2476-2479
[8]   Impact of Delirium and Recall on the Level of Distress in Patients With Advanced Cancer and Their Family Caregivers [J].
Bruera, Eduardo ;
Bush, Shirley H. ;
Willey, Jie ;
Paraskevopoulos, Timotheos ;
Li, Zhijun ;
Palmer, J. Lynn ;
Cohen, Marlene Z. ;
Msn, Debra Sivesind ;
Elsayem, Ahmed .
CANCER, 2009, 115 (09) :2004-2012
[9]  
Buckley Thomas, 2012, Dialogues Clin Neurosci, V14, P129
[10]   Death Rattle Is Not Associated with Patient Respiratory Distress: Is Pharmacologic Treatment Indicated? [J].
Campbell, Margaret L. ;
Yarandi, Hossein N. .
JOURNAL OF PALLIATIVE MEDICINE, 2013, 16 (10) :1255-1259