Death and Dying

Question 1

Palliative care myths

Answer 1

• Only available when terminal
• Recognising death is easy
• Can only receive in hospital or hospice
• Palliative medicine is morbid, do not wan to work in that field

Question 2

Key elements of palliative care

Answer 2

• Quality of life
• Neither hastens nor postpones death
• Symptom relief
• teamwork

Question 3

What are the components of a good death? Note most families fear a bad death vs death itself

Answer 3

Pain and symptom management
 Clear decision making
 Preparation for death
 Completion
 Contributing to others
 Affirmation of the person as a whole

Question 4

Why is it important to recognise dying?

Answer 4

• Allow patients and families to get used to the news
• Review care needs
• Symptom management
• Withdraw treatments that are no longer needed
• Provide counselling

Question 5

What are signs someone is dying

Answer 5

Not eating or drinking (body not requiring nutrition, little/no appetite, or fatigue)
Little/no swallow reflex, i.e. coughs when takes fluids/food
Changes in breathing, i.e. including becoming more shallow/panting/irregular/apnoeas
Changes in cognition, i.e. drowsiness to unconsciousness
Changes to skin colour, i.e. mottling/cyanosis of peripheries
Agitation and restlessness

Question 6

Timeframe for dying process

Answer 6

6-12 month risk, but may live for years: Best to start advance care planning here, progression is less reversible and Tx benefits are waning.
2-9 months left: Cognitive and physical decline is more noticeable, carers may be needed more.
1-8 weeks left: patients goals of care need revisiting
2-14 days left: deterioration is rapid
0-48 hours: actively dying