What is end-of-life care?
End-of-life care is support for people who are approaching death. It helps them to live in comfort and to die with dignity. It also includes support for their family or caregivers.
Who can provide end of life care?
Depending on the need, doctors, nurses, social workers, counsellors, physiotherapists and other professionals may be involved in end-of-life care. The team can provide the same care in a hospital or at home.
Who needs end-of-life care?
Those who are suffering from life-limiting illness and whose condition is likely to worsen require end-of-life care.
Is ICU care the same as end-of-life care?
The main aim of ICU treatment is to reverse the condition for which patient is admitted and thus help the patient return to a normal life. The efforts are focussed on curing the disease. In end-of-life care, the focus is on overall comfort of the patient. The objective is a comfortable, smooth and natural transition to death.
What are life support systems?
Life support systems include a range of devices and equipment that continuously monitor the proper functioning of vital organs and systems. When an important organ like the heart or the lungs shows signs of failing, the system issues a warning and doctors rush to attend to the problem.
How does the doctor know that a patient is dying?
The doctor carefully considers the history of the patient, the nature of the disease or medical condition, the age of the patient, and the probability and the likely impact of a sudden worsening of condition.
Is it necessary to discuss end-of-life care with the doctor?
End-of-life care involves the shifting of focus from treatment that is no longer able to cure to one that continues to ensure that the patient remains comfortable. It requires several important decisions and the doctor requires the consensus of the patient and the caregiver.
What type of treatment is given during end-of-life care?
During end-of-life care, the patient gets all care required to control pain and symptoms and to ensure comfort. This treatment may include medical management and whatever emotional or spiritual support the patient needs.
As a caregiver what are the questions I can raise about end-of-life care?
It is important to remember that, during end-of-life care, the focus is on keeping the patient comfortable. Normally, the doctor would tell you all that you need to know before starting end-of-life care. You may use the following as a general checklist. Whenever you have any question, you must ask your doctor.
- Is my patient dying?
- How much time do I have?
- Should I call our relatives?
- Is the patient in pain?
- Will it help to shift the patient to another place?
- Will the outcome be different with another treatment?
- What can happen if the treatment is stopped?
- Will the patient be more comfortable without aggressive curative treatment?
- Are we doing everything possible to keep the patient comfortable?
- Can I take the patient home?
Is it possible to provide end-of-life care at home?
Once the goal of care is defined, the location does not matter. What matters is that the patient gets services that ensure good quality of life and are delivered with compassion and care. Being at home with loved ones provides an opportunity to communicate better, share feelings, express thanks and close personal issues so that the departure is peaceful and fulfilling for all.
How can I handle an emergency, like bleeding or a breathing problem at home?
Before you take the patient home from the hospital, ask your doctor about the likely emergencies you may have to face and how to handle those. The palliative care physician can also give you this information during a home visit. You may arrange with a doctor in your neighbourhood to be on call to provide emergency support.
Is end-of-life care the same as palliative care?
Palliative care is about keeping the patient free from pain and discomfort, either or both of which may be induced by the disease as also the treatment. It has a role to play in pain management and comfort care right from the time treatment starts and continues during end-of-life care.
What kind of support can the family expect after the patient dies?
End-of-life care continues after the patient’s death as bereavement support for the family. It helps the family get through the loss of someone important. The emotional support helps the family cope with the loss and start life afresh.
How can end-of-life care be a satisfying experience for a caregiver?
A good death is as much a part of life as a good birth. End-of-life care enables the caregiver to help the patient complete the journey of life to one’s satisfaction at a phase when it matters most. It is most satisfying to facilitate a proper, peaceful leave-taking. Many caregivers consider end-of-life care as an experience that helps one grow and lead a more meaningful life.