Gregory B. Crawford, Katherine A. Hauser, and Wendy I. Janse

A Caraceni

AH Moss

AH Navigante

AP Abernethy

AS Kelley

B Gomes

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BD Onwuteaka-Philipsen

C Rhee

CD Blinderman

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Gill Highet

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IJ Higginson

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MJ Glantz

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MR Agar

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O Lindqvist

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Palliative Care Expert Group

PG Lawlor

PL Hudson

Quill TE. Perspectives on care at the close of life

R Jaiswal

R Yap

RK Portenoy

S Dein

S Fischer

S Galbraith

S Henderson

S Mercadamte

S Twomey

SA Murray

SB LeGrand

SH Bush

SM Gilbody

ST Simon

T Morita

Terri S. Armstrong

W Breitbart

World Health Organization

Crossref

Palliative Care: End-of-Life Symptoms

Caring for people at the end of their life is an important aspect of palliative care. There are international variations in language. In the United Kingdom and Australia, hospice generally refers to a philosophy of care but also relates to inpatient care, whereas in the USA hospice care is generally community-based. Even the meaning of “end of life” can be confusing. The care of people approaching the end of their life is best provided by a multidisciplinary team. Caring for people with non-curative cancers is likely to be part of the work of medical and nursing staff in almost all areas of healthcare. There will be times to seek specialist palliative care medical and nursing assistance or advice, but there is an imperative that generalists, including general practitioners or family physicians and oncologists, can provide a palliative approach to care when this is appropriate. For cancer patients and their treating physicians, one particularly challenging issue is if or when disease-modifying therapies should be ceased. Involvement of specialist palliative care and taking a palliative approach to care should be encouraged early, not merely at the end of active disease-modifying therapies. There is evidence that early involvement of palliative care may even have a survival benefit. Patients do expect their doctors to initiate conversations about end of life, and these conversations can reduce the use of intensive medical treatment at the end of life. If possible, it is best to avoid these discussions when the patient is acutely ill or distressed. It is also important to identify the onset of the terminal phase. The diagnosis of impending death is not always easy but is important to ensure appropriate care is provided. Symptom control is a significant part of the healthcare interventions provided by a palliative care team. Physical symptoms are generally well recognized and have a considerable prevalence (e.g., lack of energy (73.4%), pain (63.1%), nausea (44.7%), lack of appetite (44.5%), constipation (33.6%), cough (29.4%), and shortness of breath (22.9%)). Psychological symptoms are much more challenging to elicit, and more controversy exists about what is normal and what might require intervention. Symptoms such as anxiety and depression may not be as easily acknowledged, diagnosed, or treated by patients, carers, or healthcare providers.Gregory B. Crawford, Katherine A. Hauser, and Wendy I. Janse

Crawford, G.B.

Hauser, K.A.

Jansen, W.I.

Adelaide Research & Scholarship

Palliative care: End-of-life symptoms

https://digital.library.adelaide.edu.au/dspace/bitstream/2440/129481/3/hdl_129481.pdf

Palliative care: End-of-life symptoms

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