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Prognostication and recognition of dying 

Prognostication and recognition of dying
Prognostication and recognition of dying
Oxford Textbook of Geriatric Medicine (3 edn)

Viviana Forte

and Giovanni Gambassi


Prognosis is the science of evaluating what is like to happen in term of health outcomes (recovery, death, disability) related to a patient’s condition (cancer, chronic disease, accident). Estimating the likelihood of a life-threatening illness becomes crucial, especially among older people. It allows us to balance the benefits and burdens of diagnostic tests and treatments, to plan with the patient and family by their values, and to take care of physical, psychological, and social suffering when the disease is incurable. Validated prognostication tools are available for cancer, chronic conditions, and advanced dementia to help decision-making in the terminal phase of illness. Recognition of dying and care during the last days/hours of life should be a core competency of every physician. When a patient is actively dying, common signs tend to be present and if symptoms are not well controlled, the dying process may be prolonged and the patient may suffer unnecessarily.

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