| [ Summary ] |
Urgent problems confronted in therapy for and care of terminal stage maintenance dialysis patients who are untreatable and facing death include, 1) disclosure of condition (remaining lifespan) and prognosis, 2) notification (telling the truth) to the patient and family, 3) securing the understanding and acceptance of the patient and family, 4) developing a closer relationship to the patient and their family, 5) respecting the wishes of the patient, 6) making a plan for what measures will be performed by whom and when they will be performed (reduction of pain and suffering), 7) choice of where nursing care (end of life) will take place, 8) grief counselling for the family following death of the patient. Whichever decisions are made, it is a difficult task, often accompanied by anxiety and psychological pressure. As medical professionals, our hesitation and doubt can never be completely removed causing us to instinctively refrain from making decisions, especially when informing patients about their terminal state or when questioning them about their wishes. If this hesitation cannot be overcome, there is no hope of providing appropriate medical treatment or care for patients' terminal stage care. |