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End-of-life care is about much more than pain control

By Shari Roan
Los Angeles Times
February 28, 2012

A great deal of thought and effort has been placed into improving the final days of life for people with terminal illness in the last two decades. While pain control is a huge part of that, a study published last week in the journal PLoS Medicine demonstrates the significance of a range of caregiving measures, aside from medications, that can improve the patient’s quality of life.

The researchers interviewed staff from 16 palliative care facilities in Argentina, New Zealand and seven European countries on what nonmedication types of care they use. The study showed that taking care of the patient’s body (such as applying lotion or moisturizer), paying attention to the environment (making sure the room smells pleasant) and personalizing care (keeping familiar objects and decorations nearby) were highly valued.

“Based on these data, we argue that palliative care in the last days of life is multifaceted, with physical, psychological, social, spiritual and existential care interwoven in caregiving activities. Providing for fundamental human needs close to death appears complex and sophisticated; it is necessary to better distinguish nuances in such caregiving to acknowledge, respect and further develop end-of-life care,” the authors wrote.

In a commentary in PLoS Medicine published Tuesday, the journal’s editors called the exhaustive study a significant contribution to improving end-of-life care.

The study reveals “the complex and sometimes subtle caregiving approaches that palliative care staff take to improve the experience of dying for both patient and family,” they said. The research shows that a good quality death is possible and that health professionals should continue to pursue research aimed at improving it.