Posts Tagged ‘Balancing Hope’

Facing the end of life and the decisions they make crucial challenges for all stakeholders-patients, families, friends and doctors to accompany him. In fact, the “management” of the progression to death, especially when an urgent diagnosis is made, can be a very complex process. Each person who is often called into question in a different way.

Communication is the first goal, and it should start by physicians. In this role, physicians are often the task, the gap between the life of the supply of savings and life of the bridge, so they often struggle with balancing the hope of truth. The determination of “how much” information “, in which space of time” and “what degree of openness for this particular patient” requires a commitment that matures clever with age and experience.

A medical consultation will be strong and have a personalized forecast, the risks and benefits to consider the various interventions, the burden of symptoms in patients in the chronology, the age and stage of life of patients and quality support system for patients .

At the same time is to focus on patient and family and a side on life support, particularly when the diagnosis is first made. You must also treated for shock, which may for example complex analysis, which often reduced to give a sense of guilt, regret and anger. The fear must be directed and managed. This stage of confusion can take some time, but a sharp decline, the results of diagnostic tests or internal awareness usually signals a transition and lead patients to finally realize and understand that death is near.

After the adoption happens at the end of life decision follows naturally. Ongoing denial that death is near, that the compressed schedule for these decisions, said the fear and the sense of control over their own fate.

With the adoption of the ultimate goals of life and comfort for the rest of the days, weeks or months. Physicians, palliative care, family and other caregivers can access the assessment of symptoms in patients physical, mental focus and spiritual needs, and defining the target for end of life. How important it is perhaps for a patient to marry a granddaughter to participate or watch one last Christmas, and these goals are realistic to pursue?

On the death with dignity plan, we must confirm the death as a part of life experience instead embraced are ignored when the time comes. Are you ready?

Mike Magee, MD, is Senior Fellow in the Humanities at the World Medical Association, director of the Pfizer Medical Humanities Initiative, and the host of the weekly distribution Web “Health Policy with Dr. Mike Magee.