End of Life

Question 1

What can contribute to a good death?

Answer 1

• Symptoms well controlled
• Not distressing
• Time to plan
• Preferred place of death

Question 2

What can contribute to a bad death?

Answer 2

• Perception of failure of healthcare team
• Distressing symptoms
• Sudden
• Catastrophic event, e.g. bleed
• No time to plan ahead or achieve goals
• Disagreement

Question 3

Where do most people die?

Answer 3

In a hospital or care home

Question 4

What can enhance the quality of someone’s life?

Answer 4

• Caring attitude of staff
• Family visits
• Physical environment
• Maintaining control
• Feeling safe/ not alone

Question 5

What can the quality of someone’s life be diminished by?

Answer 5

• Lost independence
• Lost activities
• Pain/ fear of pain
• Feeling a burden

Question 6

What would you do if the patient didn’t want to know the prognosis but the family do?

Answer 6

You need to respect that it is confidential information

So you can only tell the family with the patients permission

Question 7

What is Collusion?

Answer 7

A secret agreement made between clinicians and family members to hide the diagnosis of a serious or life-threatening illness from the patient.

Question 8

What are possible reasons for collusion?

Answer 8

Disclosure causes the patient to lose hope or depression
Disclosure hastens the progression of the illness and death
Disclosure increases the risk of patient suicide
Disclosure may cause psychological pain for the patient