Communication at the End of Life

Abstract

The purpose of palliative care is to relieve the various forms of distress experienced by patients suffering from life-threatening illnesses and to improve the quality of life (QOL) of patients and their families. While medical personnel provide medication and care to alleviate distress, it is also essential to listen to patients and engage them in a continuing dialogue.The most important tool, though difficult to apply in practice, is end-of-life discussion (EOLD) [1]. EOLD helps patients come to an understanding of the limits of their lives, set their final life goals, and determine the environment in which they wish to spend their final days and what medical care they wish to receive. Such decisions affect not only the mental state of patients but also that of their family members. EOLD can be very stressful for healthcare professionals and patients, however. Doctors must ask the patients, with whom they have worked together to decide on treatment, about their wishes for their end of life after informing them that the effectiveness of treatment has decreased. In other words, doctors must inform patients about their poor prognosis in order to decide on subsequent treatment options, including palliative care. Patients must also understand their prognosis when making end-oflife decisions. It is not uncommon for both patients and medi-