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Terminal illness
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia, advanced heart disease, and for HIV/AIDS, or long COVID in bad cases, rather than for injury. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply as being terminal. There is no standardized life expectancy for a patient to be considered terminal, although it is generally months or less. An illness which is lifelong but not fatal is called a chronic condition.
Terminal patients have options for disease management after diagnosis. Examples include caregiving, continued treatment, palliative and hospice care, and physician-assisted suicide. Decisions regarding management are made by the patient and their family, although medical professionals may offer recommendations of services available to terminal patients.[1][2]
Lifestyle after diagnosis varies depending on management decisions and the nature of the disease, and there may be restrictions depending on the condition of the patient. Terminal patients may experience depression or anxiety associated with impending death, and family and caregivers may struggle with psychological burdens. Psychotherapeutic interventions may alleviate some of these burdens, and is often incorporated into palliative care.[1][3]
When terminal patients are aware of their impending deaths, they have time to prepare for care, such as advance directives and living wills, which have been shown to improve end-of-life care. While death cannot be avoided, patients can strive to die a death seen as good.[4][5][6] However, many healthcare providers are uncomfortable telling people or their families that they are dying. To avoid uncomfortable conversations, they will withhold information and evade questions.[7]
- ^ a b Lima, Liliana De; Pastrana, Tania (2016). "Opportunities for Palliative Care in Public Health". Annual Review of Public Health. 37 (1): 357–374. doi:10.1146/annurev-publhealth-032315-021448. PMID 26989831.
- ^ Hendry, Maggie; Pasterfield, Diana; Lewis, Ruth; Carter, Ben; Hodgson, Daniel; Wilkinson, Clare (1 January 2013). "Why do we want the right to die? A systematic review of the international literature on the views of patients, carers and the public on assisted dying". Palliative Medicine. 27 (1): 13–26. doi:10.1177/0269216312463623. ISSN 0269-2163. PMID 23128904. S2CID 40591389.
- ^ Block, Susan D. (2006). "Psychological Issues in End-of-Life Care". Journal of Palliative Medicine. 9 (3): 751–772. doi:10.1089/jpm.2006.9.751. PMID 16752981.
- ^ "Advance Care Planning, Preferences for Care at the End of Life | AHRQ Archive". archive.ahrq.gov. Retrieved 24 October 2017.
- ^ Qaseem, Amir; Snow, Vincenza; Shekelle, Paul; Casey, Donald E.; Cross, J. Thomas; Owens, Douglas K.; Physicians*, for the Clinical Efficacy Assessment Subcommittee of the American College of (15 January 2008). "Evidence-Based Interventions to Improve the Palliative Care of Pain, Dyspnea, and Depression at the End of Life: A Clinical Practice Guideline from the American College of Physicians". Annals of Internal Medicine. 148 (2): 141–6. doi:10.7326/0003-4819-148-2-200801150-00009. ISSN 0003-4819. PMID 18195338.
- ^ Steinhauser, Karen E.; Clipp, Elizabeth C.; McNeilly, Maya; Christakis, Nicholas A.; McIntyre, Lauren M.; Tulsky, James A. (16 May 2000). "In Search of a Good Death: Observations of Patients, Families, and Providers". Annals of Internal Medicine. 132 (10): 825–32. doi:10.7326/0003-4819-132-10-200005160-00011. ISSN 0003-4819. PMID 10819707. S2CID 14989020.
- ^ Reich, Barbara A. (17 March 2022). Intimations of Mortality: Medical Decision-Making at the End of Life. Cambridge University Press. pp. 108–112. ISBN 978-1-108-80404-2.
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