GRACE :: Treatments & Symptom Management


Death and dying

Why Not Palliative Care? Some thoughts on resistance…


I consider GRACErs a very enlightened bunch regarding of palliative care, but outside of GRACE, there remains a lot of resistance to palliative care amongst patients, families, and oncologists (medical, surgical, radiation). Why? Why do people resist even the discussion of palliative care, even in the absence of end-of-life issues?

Before I launch into further comments, a brief disclaimer: not all of this is evidence-based, but based on experience and what patients tell me when I ask them. I will also say that there are two major areas to discuss here-palliative care as a new specialty, and the difficult conversations we face when things don’t go as we wish.

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Dr West

FAQ: What might I expect to happen when someone I’m caring for is dying?


This is a difficult topic for many people to think about, and especially to bring up in a public forum, but people still want and need to know what they might expect as they or someone they care for are declining. It is understandable to fear the unknown, and to fear suffering. I would say that there are a few leading points here:

1) Most patients don’t suffer much as their cancer progresses and as they transition through the dying process.

2) This process is quite variable from one person to another, but we typically have a good idea of what a patient’s leading problems will be weeks to months before a person is experiencing a more rapid decline.

3) Engaging hospice services/palliative care can help guide expectations and generally manage many of the problems effectively by anticipating them, rather than waiting until very late to accept palliative care.

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