When a loved one nears death, our main concern for them is comfort and relieving symptoms. Once friends and family realize there is no cure, they want to ensure that their loved one is as free from pain as possible. Most patients prefer palliative care which can improve their quality of life and help with pain. This maintains their sense of well-being. For those with chronic illnesses, there are common physical problems that can be planned for ahead of time.
These include:
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- Pain. Pain is the most feared and the most common symptom of end of life. It can be caused from the progression of disease, a chronic condition or it can be related to chemotherapy among other things. Pain relief is most important because it relieves stress and helps improve the quality of life. There are many options available to manage end of life pain depending upon its severity. These range from muscle relaxants, anti-depressants and mild pain relievers to opioids such as morphine and hydromorphone.
- Dyspnoea. Dyspnoea is breathlessness or shortness of breath and is a very common end of life symptom. Though it occurs more often with lung disease it can also occur due to heart failure or other chronic conditions. Dyspnoea can be very distressing to the patient and loved ones if not addressed properly. The patient needs to be assessed to find out the cause of shortness of breath in order to determine the proper treatment.
- Problems with nutrition. Most end of life patients have very little appetite. As they approach death and the body begins to shut down, they have little need for food. If they can still swallow this is the time to consider offering them a favourite food.
Other symptoms which are common in end of life patients are mental confusion or delirium as well as agitation. Mouth and skin care is also important at this time to help the patient become more comfortable. Because of pain and breathlessness opioids are generally given continuously throughout the last 48 hours. Palliative care is important in end of life. It can help the patient to become relatively free of pain and spend their last hours in a more peaceful state. Research on symptom management is still ongoing.
