Care at the Very End-of-Life: Dying Cancer Patients and Their Chosen Family’s Needs

Abstract

The majority of cancer deaths in countries such as Australia are predictable and most likely to occur in hospital. Despite this, hospitals remain challenged by providing the best care for this fragile cohort, often believing that care with palliative intent at the very end-of-life is not the best approach to care. Given the importance that dying patients place on excellent symptom control, failing to provide good end-of-life care is likely to be contrary to the wishes of the imminently dying patient and their family. This becomes even more significant when the impact of care on the bereavement outcomes of families is considered. Given the rising numbers of predicable hospital deaths, an urgent need to address this exists, requiring health professionals to be cognisant of specific care domains already identified as significant for both patients and those closest to them in knowledge, care and affection. This non-systematic review’s aims are to summarise the symptoms most feared by people imminently facing death which is defined as the terminal phase of life, where death is imminent and likely to occur within hours to days, or very occasionally, weeks. Further, this paper will explore the incidence and management of problems that may affect the dying person which are most feared by their family. The final section of this work includes a brief discussion of the most significant issues that require attention.

Performance of care for end‐of‐life cancer patients in Tuscany: The interplay between place of care, aggressive treatments, opioids, and place of death. A retrospective cohort study

“…Finally, current data does not allow examining the influence of patient's preferences for care, thus limiting the effect of his/her choice for EOL cancer care. Literature reports that only 70% of terminally ill cancer patients die in their preferred place of death, and about 70% would have preferred home death …”

“…Literature reports that only 70% of terminally ill cancer patients die in their preferred place of death, 9 and about 70% would have preferred home death. 38,39 6 | CONCLUSIONS The aim of this paper was to shed light on the heterogeneous performance and strategies on EOL cancer patient care in Tuscany region and, in turn, on the need for better planning and reviewing of the allocation and use of costly medical services and drug treatments for end-stage cancer patients.…”

Non-curative treatment of patients with oral tongue squamous-cell carcinoma

“…The majority of patients died at the hospital and only 16% died at home. Recent studies have emphasized that the place of death influences not only the patient’s quality of life during the end-of-life period but also the mental well-being of the family members and caregivers [ 3 , 27 , 28 ]. Still, the majority of patients spend their final days at the hospital, which may be explained, at least partly, by the severity of the symptoms and, thus, by the warranted medical and technical expertise.…”

Psychosocial Interventions for End‐of‐Life Care: An Invited Commentary

“…The psychosocial consequences of a terminal illness are well established. End‐stage cancer impacts on emotional, physical, spiritual, and social wellbeing for both the individual and their family (Clark, ). Despite remarkable medical advances in the treatment of cancer, the empirical evidence regarding the psychosocial treatment at end‐of‐life care is lagging behind.…”