30.5  End-of-life care

The end of life is the terminal phase in the advanced stages of disease when the patient is expected to die in a matter of days. End-of-life care aims to recognise that life and death are normal. It neither hastens nor postpones death, it achieves the best quality of life in the time remaining, and provides good control of pain and other symptoms. It helps the dying patient and loved ones to adjust to the many losses they face, and ensures a dignified death with minimal distress. It also provides support and help for the family to cope with bereavement.

A major challenge you will face is to decide when the patient has reached the terminal phase of the illness and needs end-of-life care. A terminal illness is one for which no cure is available, and from which the patient is expected to die relatively soon.

Patients with terminal illness are usually treated with palliative care at home rather than in hospital.

Once a patient has been declared terminally ill, management of some conditions will change, and some medications may stop altogether. You may need to consult your supervisor or a nurse to help you decide when an HIV/AIDS patient is terminally ill.

30.4.5  Preventing stiff joints and muscles

30.5.1  Preparing for death