title: Symptom management in palliative care and end of life care.
abstract: There is a need for generalist- and specialist-level palliative care clinicians proficient in symptom management and care coordination. Major factors contributing to this need include changed disease processes and trajectories, improved medical techniques and diagnostic testing, successful screening for chronic conditions, and drugs that often prolong life. The rapid progressive illnesses and deaths that plagued the first half of the twentieth century have been replaced in the twenty-first century by increased survival rates. Conditions that require ongoing medical care beyond a year define the current chronic illness population. Long years of survival are often accompanied by a reduced quality of life that requires more medical and nursing care and longer home care. This article reviews the management of selected symptoms in palliative and end of life care.
authors.affiliation: Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003, USA. mbinder@chpnet.org
authors.forename: Marilyn
authors.initials: M
authors.lastname: Bookbinder
authors.forename: Marlene E
authors.initials: ME
authors.lastname: McHugh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy; D003248:Constipation / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D003693:Delirium / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D004417:Dyspnea / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D005221:Fatigue / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000503:physiopathology; D059408:Pain Management; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D013727:Terminal Care / Q000379:methods*; D014481:United States / Q000453:epidemiology