Abstract
Despite advances in cancer survival rates, end of life care remains a vital aspect
of cancer management. The use of integrated care pathways can facilitate effective
care of dying patients in a generalist setting. However, it remains important that
staff are able to recognise the onset of the dying process, not only in order to make
symptom control provision, but also that appropriate communication can occur with
patients and those close to them. This allows the exercise of choice over place and
style of care. The key symptoms at the end of life are restlessness, agitation, breathlessness,
pain and noisy respiration from retained airway secretions. Ethical tensions arise
from the assumptions that the use of opioids and sedatives hastens dying, but this
is contradicted by available evidence.
Keywords
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Article info
Publication history
Published online: March 28, 2008
Accepted:
February 25,
2008
Received:
January 10,
2008
Identification
Copyright
© 2008 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
