Terminal care in haematology.
As doctors, it is clearly our duty to continue to care for our patients if their illness is not curable. Basic skills in symptom control and counselling are needed, and if we have taken the trouble to acquire some knowledge in these respects we will be much better equipped to help the dying patient. Pain control is not complicated if approached logically. The exact cause of the pain should be treated if possible, and regular, adequately potent analgesics used to balance the pain so that analgesia is achieved throughout the 24 hours. There is nothing to be gained by withholding opiates when moderate analgesics are ineffective. The approach to the control of other symptoms is similar. Emotional care is generally more difficult and taxing to the doctor than physical care. Initially it may be difficult to decide what to tell the patient about his illness. Mistakes are less likely if the patient is allowed to indicate how much information he wants, and a vital relationship of trust can be maintained only if we tell the truth. Once this relationship of trust is established we should continue to give the opportunity for discussion of fears and worries, or sometimes simply show that we are willing to share our patient's distress. Those who depend upon us for their care deserve our commitment to them until the moment of death.
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Randall
D006402:Hematologic Diseases / Q000150:complications / Q000523:psychology / Q000628:therapy*; D006801:Humans; D010146:Pain / Q000209:etiology; D059408:Pain Management; D011369:Professional-Patient Relations; D013727:Terminal Care