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Management of the actively dying patient 

Management of the actively dying patient
Chapter:
Management of the actively dying patient
Author(s):

Judith Lacey

DOI:
10.1093/med/9780199656097.003.0181
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date: 07 May 2021

The period leading to death is characterized by increasing prevalence and intensity of physical, psychological, existential, and social concerns, and it is often a challenging time for patients, their families, and health-care providers. This chapter specifically addresses the most prevalent symptoms and concerns encountered when managing the actively dying patient. Symptoms affecting dying patients’ comfort, including pain, dyspnoea, delirium, terminal secretions, and refractory symptoms and suffering require different clinical management as death approaches. Other topics included are recognizing the dying phase; communication with and preparation of patient, family, and staff; anticipating dying-advanced care planning and approach to resuscitation; addressing psychosocial and existential concerns; and approach to difficult end-of-life scenarios. This chapter aims to provide the health-care practitioner with a good overview and approach to the whole-person care needs of the dying patient and their family and carers to enable health practitioners to feel comfortable in providing this important care with confidence.

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