end-of-life care


Also found in: Dictionary, Thesaurus, Legal, Encyclopedia, Wikipedia.

end-of-life care

multidimensional and multidisciplinary physical, emotional, and spiritual care of the patient with terminal illness, including support of family and caregivers.

End-of-life care has received increasing attention in recent years. The pioneering studies of Elisabeth Kübler-Ross on death and dying, begun in the the 1960s, have afforded valuable insights into the evolving emotions, experiences, and needs of the dying person. Health care professionals have formally recognized the importance of rendering humane and competent care at the end of life in ways that preserve the dignity and autonomy of the patient. Physicians, particularly oncologists, who treat patients with terminal illness have focused on the need to distinguish clearly between aggressive and palliative forms of treatment and to establish guidelines for the care of patients for whom further cure-oriented treatment will be of no benefit. In particular, they have recognized the importance of providing adequate pain relief to patients with advanced cancer. Increased attention has also been given to the control of fatigue, anorexia, cachexia, nausea, vomiting, and dyspnea, which often occur in terminal illness. Studies have shown that pain relief in terminal patients is often inadequate because physicians are afraid of inducing narcotic addiction or of being accused of hastening death. Wider use of opioid analgesics and development of patient-controlled analgesia and anesthesia systems have improved control of pain in terminal cancer and AIDS. Professional nurses have embraced the obligation to provide relief of suffering, comfort, companionship, and, when possible, a death that is congruent with the dying person's wishes. The hospice movement has established programs and facilities within the organized health care system that focus on the special needs of dying patients for comfort and care rather than efforts at cure. These programs include support of caregivers and family members during and after the patients' final illness. There is general ethical consensus that the withholding or withdrawal of life-sustaining treatments in terminal illness is not euthanasia but rather a decision to allow the disease to follow its natural course. End-of-life care emphasizes the importance of frank, timely, supportive discussion of such matters as preferences for life-extending care, including cardiopulmonary resuscitation, mechanical ventilation, artificial hydration and nutrition, renal dialysis, and surgery before decisions about the use of such measures become necessary. Legislatures have sought to preserve the dignity and independence of people nearing the end of life by allowing them to enact advance directives for their care in the event that they become incompetent or comatose. The integrity of the relationship between patients and health professionals has been threatened by growing social and legal toleration of physician-assisted suicide. The American Medical Association and the American Nurses Association have issued official position statements opposing assisted suicide. see also advance directive, physician-assisted suicide, living will.

end-of-life care

n.
The network of medical and support services, including palliative care, hospice, psychological counseling, and legal assistance, provided to individuals in the last stages of a terminal illness.

end-of-life care

(end līf kār)
Multidimensional and multidisciplinary physical, emotional, and spiritual care of the patient with terminal illness, including support of family and caregivers.

end-of-life care

Supportive care for the dying. Such care includes invasive interventions such as advanced cardiac life support, or supportive interventions, such as educational, emotional, physical, or social assistance to the terminally ill and their families and significant others.
See also: care
References in periodicals archive ?
Many people rely on their primary care providers to direct them to the best care when it comes to end-of-life care decisions, said Porter Storey, MD, FACP, FAAHPM, executive vice president of the American Academy of Hospice and Palliative Medicine.
See also: Aetna backs Medicare plan end-of-life care changes
The pressure of attending to such pressing practicalities reduces the opportunities for conversations about end-of-life care wishes between the patient and carer.
Blackmer's statement on the continuum of palliative contradicts Quebec's euthanasia Bill 52 that defines euthanasia as part of the continuum of end-of-life care that includes palliative care.
Edmonds, a palliative care specialist in San Diego, has developed a list of common decisions and life choices that create opportunities for advisors to bring up the topic of end-of-life care.
In fact, programs such as the Institute for Health Care Improvement's Conversation Project are making great strides and in the fall of 2012 the state of Massachusetts initiated the Medical Orders of Life Sustaining Treatment program to improve effective, comprehensive discussions centered on patient wishes regarding end-of-life care.
Chen and his associates at Johns Hopkins' comprehensive cancer center helped change patient and family decisions regarding end-of-life care during a 4-year period and decreased use of intensive or invasive procedures in the last 6 months of life.
The students were given the assignment to watch a video regarding the ethics of end-of-life care in the U.
Improving end-of-life care should be a national priority, not just from a cost perspective, but from a quality perspective, because we can do much better" (Carlson, 2010, p.
Although I have enjoyed the dynamics of critical care for more than 30 years, the provision of end-of-life care and being present in the most intimate moments of a patient's and family's life have been extremely rewarding.
The new study compared end-of-life care for older patients with non-small cell lung cancer (NSCLC) in the United States and Ontario.
HEALTHCARE commissioners must prioritise end-of-life care to ensure people's choices are met and to avoid unnecessary emergency hospital admissions, according to new advice published.