Paliatívna medicína a liečba bolesti 2e/2016

Basic principles in approaching patient and his family in the terminal phase of cancer

Serious life threatening disease including cancer appears to be not exclusively a medical problem. The stepwise treatment failure opens up a dilemma for patient and physician on how to cope with the new situation. Especially, disclosure of the reality by health care providers with an emphatic feeling is coupled with emotional pressure that is for many caregivers difficult to accept. The decision around the termination of curative treatment and the transition to palliative care is the most stressful event in the relation of caregivers to the the patient and his family. The patient being in the terminal phase of his disease is suffering from deep psychosocial crisis and the doctor-patient communication remains the only possibility of helping patient to accept the reality of approaching death. The disclosure of „bad news“ is a stressful moment for caregivers themselves, that, besides of emphaty, deserve communication skills and theoretical and professional preparedness. The aim of this paper is to open up a discussion about the most stressful life phase – dying and death – in the context of biomedical and psychosocial care of patients with serious life threatening disease.

Keywords: terminal phase, dying, death, stress, emphaty, psychosocial care