Acute Medicine | Palliative care | Influence of transition points and crises on decision-making in symptom management

Influence of transition points and crises on decision-making in symptom management
Session overview
Description
This session discusses how to deal with transition points and crises, both in terms of initial management options and how these options can be explained and discussed with patients approaching the end of life and their relatives and carers. The ways in which these transition points and crises influence decision-making in symptom management are explored.

This session was reviewed by Ros Henderson and Sarah Hanrott and last updated in September 2023.

Learning objectives
By the end of this session you will be able to:

• explain the need to be alert for changes such as infections and unexpected crises in a patient’s condition, which may mark transition points in an end of life population
• assess the signs and symptoms of change and outline initial management options
• recognise the impact of infections, transition points and crises on patients approaching the end of life and family and carers
• outline how you can provide supportive communication and information about infections, transition points and crises, so that sensible and appropriate decisions related to symptom management can be made

In end-of-life care, symptom management takes place within the context of advancing incurable illness.

As patients approach the end of life, the burden of their physical illness increases, and their capacity to resist additional complications, such as infection, is reduced.

Professionals need to be alert for changes such as infections and unexpected crises, which may mark transition points in an end of life population.

This session discusses how to deal with transition points and crises, both in terms of initial management options and how these options can be explained and discussed with patients, and where appropriate relatives and carers, so that sensible decisions are made.