Clinical Challenges to the Delivery of End-of-Life Care

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End-of-life care presents many challenges (e.g., the management of pain and suffering) for clinicians, as well as for patients and their families. Moreover, the care of the dying patient must be considered within the context of the psychological, physical, and social experiences of a person’s life.1 Foremost among those who require end-of-life care are the elderly, who are prone to loneliness, who frequently underreport pain, and who have a greater sensitivity to drugs and to drug-drug interactions. 2 Unfortunately, clinicians who are responsible for the treatment of patients at the end of life commonly lack adequate training to help guide end-of-life decisions and to deliver bad news to patients and families. 3,4 They must also face their own discomfort with discussions about death and deal with poor compensation for the time spent discussing end-of-life care with patients and families. Given the unique process of each person’s death, algorithmic strategies are often inadequate to guide patients, their families, and the clinicians who care for them through this complex and emotionally challenging process.​

Prim Care Companion J Clin Psychiatry 2006;8(6):367-372