CPD Articles

How to approach patients and families at the end of life

Maggie De Swardt, Rene Krause, Louis S. Jenkins
South African Family Practice | Vol 66, No 1 : Part 4| a5916 | DOI: https://doi.org/10.4102/safp.v66i1.5916 | © 2024 Maggie De Swardt, Rene Krause, Louis S. Jenkins | This work is licensed under CC Attribution 4.0
Submitted: 27 January 2024 | Published: 24 April 2024

About the author(s)

Maggie De Swardt, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Rene Krause, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Louis S. Jenkins, Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and Primary Health Care Directorate, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and Department of Family and Emergency Medicine, Western Cape Department of Health, George Hospital, George, South Africa

Abstract

Healthcare practitioners are regularly faced with treating patients at the end of their life, and this can be very daunting. This article hopes to help the practitioner have an approach to managing end-of-life care that makes it less distressing. The symptoms at the end-of-life include delirium and/or agitation, breathing changes, skin changes, sleeping more, decrease in need for food and drink, incontinence, and increased secretions. These symptoms are discussed and practical ways of management are given. The article further discusses how to approach the difficult conversation with the family and gives guidance as to what needs to be discussed. A number of tips are discussed on how to prepare the family to handle a death at home. It is essential to look at coping mechanisms and selfcare for practitioners dealing with end-of-life care as the death of a patient not only affects the family but also the practitioner.

Keywords

palliative care; end-of-life; multi-professional teams; symptoms; difficult conversation.

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