Articles: palliative-care.
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To review the evidence on the effectiveness of medical management of bowel obstruction for patients with advanced cancer and to summarize treatment options for home and hospital care. ⋯ Pharmacologic management and percutaneous gastrostomy for intractable vomiting and hypodermoclysis or oral fluids for hydration can control symptoms without surgery or nasogastric tubes.
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This paper explores one facet of a therapeutic relationship with a woman suffering from inoperable cervical cancer. The psychotherapy sessions were conducted in both hospital and the family home and continued on a weekly basis until final termination immediately prior to the woman's death. Through a "suspense structure' case study narrative, the writer, a nurse psychotherapist, describes the way in which the humanities, art and poetry can provide a means through which to understand seemingly incomprehensible feelings related to reviewing past events as a preparation for death. ⋯ The author proposes that engagement in a therapeutic relationship with a dying person presents the worker with parallel struggles manifesting in elementary feelings which require discernment. The central recommendation of this paper is that the rich symbolic language and metaphors, redolent in art and poetry, be harnessed as a potent therapeutic tool. Throughout the discussion, the terms counselling and psychotherapy are used interchangeably.
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Nowadays, more people seem to die in hospitals or other establishments than in their own homes. The following paper reports on 50 consecutive cases of death that occurred in a clinic of internal medicine. The analysis concentrated on the circumstances, the symptoms and the treatment of the patients during the 12 h. preceding and immediately before death as well as on the opinion of the relatives and the attending staff. ⋯ So we should sometimes question ourselves about the sense and the need of certain nursing interventions. We should spend more time during our medical training on the question of palliative care and on the problem of the relationship of doctors to death and to the dying. We feel that establishing a "science of death" or a segregation of the dying in specialized institutions makes no sense.