Acute Medicine | Palliative care | Managing distress during the dying phase

Managing distress during the dying phase
Session overview
Description
This session discusses heightened distress in patients at the end of life. It offers strategies and suggestions for professionals to identify distress and to provide appropriate support for the patient, relatives and carers during the dying phase - the last few weeks of life.

This session was reviewed by Richard Kitchen and last updated in May 2021.

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

• recognise the patient's distress in the dying phase
• recognise distress in the carer or family member in the patient's dying phase
• recognise the early signs of distress being experienced by patient, relative or carer, and assess its cause and severity
• identify strategies to address patient or family distress including acknowledging that distress is natural and appropriate given the current circumstances
• recognise and manage your own distress in the patient's dying phase

Dying is a natural part of life, and for end of life care patients, the dying phase is usually expected. However, facing the 'reality' of imminent death may precipitate unpredicted expressions of emotional distress by the patient or their relatives and carers.

This session discusses the experience of patient and carer distress. It explores some of the key causes, reasons and motivations behind distress. It also discusses how professionals can pick up the signs early and acknowledge, provide support and often alleviate distress for the patient, their relatives and carers during the last few weeks of life.

An expression of a patient's wishes about their ongoing medical care towards the end of life may have been completed earlier in the patient's life as an advance care plan. This advance care plan may diminish the patient and/or their family's distress or depression in this dying phase.

Finally, the session acknowledges that there are occasions when we ourselves can feel a raised level of distress in caring for a dying patient, and explores the importance for professionals in recognising and managing their own distress in these situations.