End of Life Care

Dec 1, 2000 Issue
A Daughter Estranged from Her Dying Father [Curbside Consultation]

This case scenario clearly represents the challenges, complexities and paradoxes often faced by physicians working with dying patients and their families. Views and reactions regarding the end of life encompass a breadth of emotional, spiritual, personal and cultural factors that may take us far from standard medical practice.

Oct 1, 2000 Issue
Withholding and Withdrawing Life-Sustaining Treatment [Article]

Withholding or withdrawing life-sustaining therapies is ethical and medically appropriate in some circumstances. This article summarizes the American Medical Association's Education for Physicians on End-of-life Care (EPEC) curriculum module on withholding or withdrawing therapy. Before reviewing sp...

Jul 1, 2000 Issue
A Daughter Who Won't Let Her Mother Go [Curbside Consultation]

The family physician submitting this case is to be commended for wrestling with a very difficult problem. The patient's family physician has taken an appropriate first step in the management of this situation by setting boundaries through a verbal contract about limits in providing care for the mother.

Feb 1, 2000 Issue
Managing Pain in the Dying Patient [Article]

End-of-life care can be a challenge requiring the full range of a family physician's skills. Significant pain is common but is often undertreated despite available medications and technology. Starting with an appropriate assessment and following recommended guidelines on the use of analgesics, famil...

Oct 1, 1999 Issue
Approaching a Terminally Ill Patient in Denial [Curbside Consultation]

Denial is a common coping mechanism for those facing a terminal illness—most people use denial to one degree or another, denying some aspects of their illness at least some of the time.

Feb 1, 1999 Issue
Incorporating Advance Care Planning into Family Practice [Article]

Despite widespread support for the concept of advance care planning, few Americans have a living will or a health care proxy. Advance care planning offers the patient the opportunity to have an ongoing dialog with his or her relatives and family physician regarding choices for care at the end of lif...

Feb 1, 1998 Issue
Hospice Care in the Nursing Home [Article]

Hospice care is being used more frequently to provide skills and services that are not otherwise available in nursing homes. For eligible terminally ill patients, the Medicare Hospice Benefit supplies an interdisciplinary team with skills in pain management, symptom control and bereavement assistanc...

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