title: Care at the Very End-of-Life: Dying Cancer Patients and Their Chosen Family's Needs.
abstract: The majority of cancer deaths in countries such as Australia are predictable and most likely to occur in hospital. Despite this, hospitals remain challenged by providing the best care for this fragile cohort, often believing that care with palliative intent at the very end-of-life is not the best approach to care. Given the importance that dying patients place on excellent symptom control, failing to provide good end-of-life care is likely to be contrary to the wishes of the imminently dying patient and their family. This becomes even more significant when the impact of care on the bereavement outcomes of families is considered. Given the rising numbers of predicable hospital deaths, an urgent need to address this exists, requiring health professionals to be cognisant of specific care domains already identified as significant for both patients and those closest to them in knowledge, care and affection. This non-systematic review's aims are to summarise the symptoms most feared by people imminently facing death which is defined as the terminal phase of life, where death is imminent and likely to occur within hours to days, or very occasionally, weeks. Further, this paper will explore the incidence and management of problems that may affect the dying person which are most feared by their family. The final section of this work includes a brief discussion of the most significant issues that require attention.
authors.affiliation: Cancer and Palliative Care Network Northern Sydney Local Health District, Royal North Shore Hospital, Pacific Highway, St Leonards, NSW 2065, Australia. Katherine.clark@health.nsw.gov.au.|School of Medicine and Public Health, the University of Newcastle, Newcastle, NSW 2981, Australia. Katherine.clark@health.nsw.gov.au.
authors.forename: Katherine
authors.initials: K
authors.lastname: Clark
keywords: care needs; care of the dying; symptom control