Only one chance to get it right: end of life care
Mari Lloyd-Williams, Sanjay Shah, and Idris Baker explain the fundamentals of palliative care and supporting dying patients
End of life care is an art--it is a challenging and essential area of medical practice. There is no specialty without such responsibility at least from time to time.
Components of such care includes identifying that death is approaching; discussion with the patient and family and carers or both; the identification and management of distressing symptoms; support for family and carers and bereavement support; and, if we are to do it well, looking after ourselves.
In this article we refer to the last few days of life, when the final decline on the background of a progressive illness has begun--this is not always easy to identify and others' perspectives must be added to it. Nursing staff have longer periods of direct patient contact and their impression should be noted. Families (in which we include all “significant others” and not only relatives) and, when lucid, patients may perceive signs of imminent