The sadness and inevitability of death brings problems and difficulties that few persons have the knowledge or experience to cope with alone. Most persons would like to die at home close to family and familiar possessions. Every help must be given to the patient who wishes to die at home and not in a hospital. The expense of prolonged hospitalization is often prohibitive, and this is an additional psychological as well as financial burden for the patient and family.
Some persons have more experience of helping with the dying than others. The physician knows about the patient’s physical needs and has the skill to prevent or relieve pain. He or she becomes a leader and supports the family during the weeks ahead. A member of the clergy can give a spiritual support that may not have been needed by the patient or the family for many years.
At the onset of a terminal illness, the physician and family are faced with the decision of what to tell the patient. If the course of the illness is rapid, the decision may not have to be made. The problem usually arises when an inoperable cancer is present; when there is an incurable muscular disorder; or when a cardiac condition begins to rapidly deteriorate. Often the patient’s mental state remains unaffected and alert.
