| Abstract;When terminally ill patients understand their physical condition, they realize that they have to let go of many objects, including the people whom they have loved. Most dying patients in Japan have no expectation or hope of an eternal future. Because of this, they feel there is no meaning to the remainder of their lives. To help patients in this stage, their illness must be clearly explained, if that is their wishes. The family of the patient can help to diminish the mental and physical suffering by taking an active role in the care of the patient. The patient, his or her family and the medical staff should be prepared to discuss the life of the patient and also the life of the family. This open discussion often serves to calm the patient. To facilitate this dialog, the medical staff, in particular the physician in charge, must be prepared to see the patient when he or she asks. It is also desirable to spend time with the patient, whether there is conversation or not. Furthermore, physical pain must be controlled to the greatest extent. The family should be prepared to care for the patient even if she is hospitalized. It is critical at this stage to understand the patient's suffering and her hopes. One of the main conclusions of this study is that the dying patient and their family should be regarded as one unit. If the family takes an active role in caring for the patient, the patient is given hope because she wants to live for her family, and the family members, in turn, obtain satisfaction through their caregiving and come to accept the patient's death. (author abst.) |
