Palliative Therapy for Terminal illnesses
Terminal care is that care a patient is given in the end stages of disease before death. Terminal and palliative care services are important to the family physician, because most patients want to die at home. Therefore most patients arrived at this stage refuse admission or if admitted to hospital discharge request.
The most common diseases that reach irreversible phase are :-
a. Pulmonary fibrosis, pulmonary failure
b. Heart failure
c. Liver cirrhosis
d. Chronic renal failure
e. Parkinson’s disease, multiple sclerosis, demented
f. Lung cancer, stomach cancer, liver cancer, lymphoma, etc.
Disclosure of the diagnosis of incurable stage: Although the diagnosis of cancer or cirrhosis has been some bad news, the diagnosis of incurable stage is much worse news because it means death within a relatively short period of the sick person. However the family physician must communicate this to the patient and family. To communicate the diagnosis of incurable stage, the family doctor must first determine whether the patient would like to know this and if it is ready to learn, and if the patient would like to know the truth about his illness, the family doctor patient must communicate this with more tact:
a. To find the time and place
b. To respect the to the patient sensitivity
c. use appropriate expression according to the level of understanding of to the patient
d. to show compassion and attachment
e. to respond to the patient questions
f. Do not rule out any hope of the sick person
g. Establish realistic objectives
h. To ensure the patient that it will do everything possible
Palliative Therapy for the patient and family
Palliative therapy for the patients: Most patients in irreversible stage show a state of anxiety and mental depression. Therefore patients suffering irreversible phase must be supported psychological doctor. Although we can not expect an improvement in the health of the patient, supportive psychotherapy is needed to combat anxiety and depression, the patient’s condition worsens.
Palliative Therapy for the family : As the illness of a family member is a very important stress and death of a family member is an even greater stress, the family doctor must give due weight and psychological support of the family. In this sense, the family doctor should inform their family and to prepare properly, to learn what to do.
Spiritual support to patient : Although of the sick person spiritual support is required in all cases, but perhaps in any other situation, of the sick person spiritual support is not necessary in terminal stages of life. For in no other situation of life the patient is not tempted to question the meaning of life and death.
Therefore the family doctor is supposed to listen to the patient that addresses these problems. Help him understand the deep meanings of life and death. In this respect, as well as the family doctor to work with the priest, the psychiatrist and psychologist.
Providing a dignified end : Though the disease is incurable and one cannot do anything to stop the disease, the patient needs to have a dignified end. As shown in medical ethics code, incurable patients should be treated with the same care and attention as other patients. And as shown in the Declaration concerning the rights of the patient, any person is entitled to human care and to die in dignity.