Therapeutic Approach to the Patient with a

Life-Threatening Illness

ICBS 120Chapter 6

What is a Life-Threatening Illness?

Words that may be used:

Terminal; believed to remove any hope from the situation.

Life-threatening for one person, may not be for another.

Life-threatening is used to imply life may be shortened.

Death that is imminent or a serious illness.

Cultural Influences

Defined: culture is how we live our lives, how we think, how we speak, and how we behave.

• In some cultures, pain is to be endured quietly and can result in stress.

• The strongest influence in managing any life-threatening illness is the family and those closest to the patient.

Choices in Life-Threatening Illness

Main Reason for discussing patient’s needs:Give the patient the power in dealing with the illness.

• Alternative methods of treatment should be discussed with patient as should pain management and various treatment methods..

• A durable power of attorney for healthcare and/or a living will or physician’s directive.

• It is NOT appropriate to discuss planning for a funeral.

Choices in Life-Threatening Illness Cont’d

• Finances are to be considered.

• Emotional needs of the patient and family members are important as is their support.

Range of Psychological Suffering

Range can be from mild to extensive symptoms of:

• Distress• Anxiety• Depression• Denial• Numbness

Symptoms can be:Tension, tachycardia, agitation, insomnia, anorexia and panic attacks

Patients with HIV/AIDS

• Tend to live longer with various treatments but their immune system is compromised.

• Experience guilt based on past behavior.

• May be estranged from their family.

• Experience additional stress/strain.

Patients with Cancer

Three most likely treatmetns for Cancer:

1. Surgery

2. Radiation

3. Chemotherapy

NOTE: Sometimes it takes a combination of all three.

ESRD (End-Stage Renal Disease)

Defined: When the kidneys fail completely and

patients cannot live long unless they receive

dialysis (replacing the main function of the

kidney such as filtering) or a transplant.

ESRD (End-Stage Renal Disease) Symptoms

• Mild to severe itching• Mild confusion or disorientation• Hallucinations• Agitation• Decrease in appetite• Rapid, shallow breathing• Edema or swelling of the body• Loss of energy and sleep, lethargic.

Stages of Grief

• .Denial

• Anger

• Bargaining

• Depression

• Acceptance