Palliative Care in the End-of-Life Period
Keywords:
palliative care, end of life, dying, suffering relief, palliative sedationAbstract
Palliative care at the end of life is only a minor part of the holistic palliative care, which usually starts in the early age of the chronic non-curable disease progression. When it comes to patients’ end-of-life care, we speak of a very short survival period being evaluated in the hours or days, or very rarely, weeks. This is a specific time in which distinctive signs of approaching death are beginning to appear. Recognition of this period and appropriate planning is essential. Patients and their caregivers should be at the centre of planning and managing the care. Communication is particularly vital since patients and their caregivers can adequately participate only if they are properly informed. Management of personal hygiene, skin and mouth care, bowel and bladder function and most common symptoms (pain, dyspnoea, delirium, agitation and terminal secretions
(death rattle) are also important. Occasionally, initiation of palliative sedation is needed if all standard palliative interventions do not alleviate the symptoms and suffering.
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