End of Life Care

Jun 1, 2006 Issue
Determining Prognoses for Patients with Terminal Illnesses [Curbside Consultation]

Physicians often overestimate a terminal patient's life expectancy.

Mar 15, 2006 Issue
Guidelines for Delivering Quality Palliative Care [Practice Guidelines]

The National Consensus Project for Quality Palliative Care (NCP), representing five major U.S. palliative care organizations, has established guidelines to promote consistent and high-quality palliative care and to guide the structure and development of existing services.

Oct 1, 2005 Issue
Respecting End-of-Life Treatment Preferences [Article]

Most patients eventually must face the process of planning for their future medical care. However, few Americans have a living will or a durable power of attorney for health care. Although advance directives provide a legal basis for physicians to carry out treatment using a health care proxy or a l...

Feb 1, 2005 Issue
Cultural Diversity at the End of Life: Issues and Guidelines for Family Physicians [Article]

Ethnic minorities currently compose approximately one third of the population of the United States. The U.S. model of health care, which values autonomy in medical decision making, is not easily applied to members of some racial or ethnic groups. Cultural factors strongly influence patients' reactio...

Aug 15, 2004 Issue
Making Decisions with Families at the End of Life [Article]

Because advance directives are not yet the norm, end-of-life decisions for patients without medical decision-making capacity are made regularly within discussions between the patient's physician and family. Communication and decision making in these situations require a complex integration of releva...

May 1, 2003 Issue
Do I Have to Resuscitate This Patient Against Her Wishes? [Curbside Consultation]

In this case scenario, the family physician successfully performed a task that often is forgotten during physician-patient visits—the physician frequently discussed with this patient her wishes for end-of-life care. The conversations specifically included her thoughts about respirators, CPR, and other potential life-prolonging treatments.

Dec 15, 2001 Issue
Breaking Bad News [Article]

Breaking bad news is one of a physician's most difficult duties, yet medical education typically offers little formal preparation for this daunting task. Without proper training, the discomfort and uncertainty associated with breaking bad news may lead physicians to emotionally disengage from patien...

Oct 1, 2001 Issue
Challenges in Pain Management at the End of Life [Article]

Effective pain management in the terminally ill patient requires an understanding of pain control strategies. Ongoing assessment of pain is crucial and can be accomplished using various forms and scales. It is also important to determine if the pain is nociceptive (somatic or visceral pain) or neuro...

Sep 15, 2001 Issue
Management of Common Symptoms in Terminally Ill Patients: Part II. Constipation, Delirium and Dyspnea [Article]

In addition to pain, patients who are approaching the end of life commonly have other symptoms. Unless contraindicated, prophylaxis with a gastrointestinal motility stimulant laxative and a stool softener is appropriate in terminally ill patients who are being given opioids. Patients with low perfor...

Sep 1, 2001 Issue
Management of Common Symptoms in Terminally Ill Patients: Part I. Fatigue, Anorexia, Cachexia, Nausea and Vomiting [Article]

Physical symptoms other than pain often contribute to suffering near the end of life. In addition to pain, the most common symptoms in the terminal stages of an illness such as cancer or acquired immunodeficiency syndrome are fatigue, anorexia, cachexia, nausea, vomiting, constipation, delirium and ...

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