End of life care in chronic obstructive pulmonary disease: in search of a good death.
Chronic obstructive pulmonary disease (COPD) is an incurable, progressive illness that is the fourth commonest cause of death worldwide. Death tends to occur after a prolonged functional decline associated with uncontrolled symptoms, emotional distress and social isolation. There is increasing evidence that the end of life needs of those with advanced COPD are not being met by existing services. Many barriers hinder the provision of good end of life care in COPD, including the inherent difficulties in determining prognosis. This review provides an evidence-based approach to overcoming these barriers, summarising current evidence and highlighting areas for future research. Topics include end of life needs, symptom control, advance care planning, and service development to improve the quality of end of life care.
Spathis
Anna
A
Palliative Care Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England, UK.
Booth
Sara
S
D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D013727:Terminal Care / Q000458:organization & administration*