Psych
End-Of-Life Care
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End-Of-Life Care
, Discussing Death, Discussing Terminal Illness
See Also
Cancer Symptom
Breaking Bad News
Preparatory Grief
Grief
Mood Disorders in Cancer
Management
Communication
See
Breaking Bad News
Communicate prognosis
Delay prognosis discussion until after accurate cancer staging
Gauge how much information patient wants about the prognosis
Discuss 5-10 year survival rates with and without treatment
Communicate empathically without expressing false hope
Review disease natural course with and without treatment
Discuss treatment and potential adverse effects
Discuss expected quality of life
Address patient fears (e.g. suffering, abandonment)
Three approaches
Hope for the best and prepare for the worst (spectrum of possibilities) or
Provide patient with information on full spectrum of treatment or
Provide patient with sequential treatment options as events arise
Discuss disease transition
Goal: Extend life and improve quality of life (treatment and
Palliative Care
)
Discuss care coordination
Parallel follow-up visits with both primary care and sub-specialists
Communication among patient's medical providers
Management
Symptoms
See
Cancer Symptom
for specific management
References
Ngo-Metzger (2008) Am Fam Physician 77:167-74 [PubMed]
Fallowfield (2004) Lancet 363:312-9 [PubMed]
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