End-of-life care for the hospitalized patient

Med Clin North Am. 2002 Jul;86(4):749-70, viii. doi: 10.1016/s0025-7125(02)00017-2.

Abstract

The majority of Americans die in hospitals where shortcomings in end-of-life care are endemic. Too often, patients die alone, in pain, their wishes unheeded by their physicians. Because hospitalists care for many of these dying patients, they can dramatically improve end-of-life care in hospitals. Hospitalists must first relieve distressing symptoms such as pain, dyspnea, nausea, vomiting, delirium, and depression. In addition, they should communicate clearly with patients and families, and provide them psychosocial support. Hospitalists can increase the number and the timeliness of hospice referrals, thereby allowing more patients to die at home. Finally, all physicians must attend to their own senses of grief and loss to avoid burnout and to continue to reap the rewards end-of-life care provides.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Counseling
  • Empathy
  • Ethics, Clinical
  • Ethics, Medical
  • Family / psychology
  • Grief
  • Hospitalists / standards*
  • Hospitalization
  • Humans
  • Palliative Care / methods
  • Palliative Care / standards*
  • Physician's Role*
  • Physician-Patient Relations
  • Quality of Health Care
  • Terminal Care / methods
  • Terminal Care / standards*
  • Terminally Ill*
  • United States