What is a „good death”? The needs of patients during their last days

Abstract

In order to provide patients with optimal end-of-life care, it is central to recognize the moment when dying actually begins and to be able to anticipate problems which may occur during this time, especially concerning pain and other symptoms control. Immediate access to hospice care, regardless of the place of dying, is very helpful to achieve this aim. Ensuring the feeling of dignity and privacy, the right to choose the place of dying and to receive spiritual support are no less important. Other elements of the “good death” are: access to information about the state of the illness, a possibility of expressing the will with a guarantee of its fulfilment and a farewell to the nearest and dearest. The duration of agony is also a factor taken into consideration in the death quality assessment process. The physicians’ and carers’ efforts should be based on the acceptance of the moment of natural death and should not aim at prolonging the last phase of dying. What is indispensable for the doctors who want to accompany their patients in the last period of life in the best way possible is good knowledge of the symptomatic treatment, improvement the skill of conversation both with the patient and his family on the difficult topic of the end of life and acute awareness of the need to provide for both the physical needs of the patient and the spiritual and psychological ones.