Chapter 28: End of life care
Skip chapter table of contents and go to main content
Evidence‐based approaches
Palliative care is relatively new as a specialty in nursing and medicine and its evidence base is therefore comparatively small, though growing. Nursing care of the dying patient should have as its main priority meeting personal needs that will allow the patient to have a ‘good’ death. It has been suggested that the following characteristics are central to a ‘good’ death from medical, nursing and patient perspectives: (1) control, (2) comfort, (3) closure, (4) trust in healthcare providers, (5) recognition of impending death, and (6) an honouring of personal beliefs and values (Kehl [27]).
The WHO ([61]) suggests that palliative care:
- provides relief from pain and other distressing symptoms
- affirms life and regards dying as a normal process
- intends neither to hasten nor postpone death
- integrates the psychological and spiritual aspects of patient care
- offers a support system to help patients live as actively as possible until death
- offers a support system to help the family cope during the patient's illness and in their own bereavement
- uses a team approach to address the needs of patients and their families, including bereavement counselling if indicated
- enhances quality of life and may also positively influence the course of an illness
- is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy and radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.
