Symptom management strategies for dying patients

When the patient is near death, a constellation of unpleasant symptoms may characterize the experience regardless of the diagnosis. The patient and family will experience a "bad death" if the patient's distress is not alleviated. When the patient is near death, the most relevant clinical goal is to palliate symptoms of distress by identification and implementation of relevant care strategies. A review of the entire therapeutic plan, including routine interventions, needs to be done. Many standing interventions can be sources of discomfort for the dying patient, thus a comprehensive benefit vs. burden analysis of the treatment regimen must be done. Clinicians may overtreat dying patients because they have not been trained in clinical aspects of such care. Effective strategies exist to relieve distress from the most common complaints of dying patients: pain, dyspnea, nausea/vomiting, fear, anxiety, and delirium.