Patients with renal disease End-stage renal disease (ESRD) is the term used to describe a degree of chronic renal failure that, without dialysis or kidney transplantation, would end the patient’s…

Patients with pulmonary disease The pulmonary disorders most likely to lead to end-of-life care — other than lung cancer, which is addressed in Chapter 8 — are chronic obstructive pulmonary…

Patients with neurologic disease Several neurologic disorders follow a degenerative course that eventually results in the patient’s death. These disorders impact quality of life for both patients and families, in…

Patients with heart failure About 5 million Americans have heart failure and, despite advances in treatment, deaths from heart failure continue to rise. About 1 in 4 people die within…

Patients with cancer Cancer is the second leading cause of death in the United States and the most common diagnosis in palliative and hospice care. The latter fact probably stems…

Psychosocial, spiritual, and cultural care In end-of-life care, no matter what the patient’s particular diagnosis, the goal of the palliative care team is to relieve the patient’s symptoms and help…

Palliative drug therapy Almost invariably, dying patients receive many drugs and undergo various degrees of organ failure before reaching the end of life. Both of these issues will complicate your…

Evidence-based care The philosophy that underlies palliative care is relatively simple: to minimize suffering and maximize quality of life. At the end of a patient’s life, palliative care replaces curative…

Legal considerations If you’re involved in end-of-life care, you’ll be better able to act as an advocate for your patient and his family if you have a working knowledge of…

Ethical considerations When caring for dying patients, you’ll almost certainly encounter ethical challenges as varied as the patients themselves. However, certain topics tend to arise over and over. Some of…