[Evaluation of palliative care in the terminal stage]

One can't measure love, beauty and happiness. On the other hand, we all have experience of the intensity of these qualities when we feel that we "possess" them for a very short time. The patient who is terminally ill knows that time is short. There is therefore a great need for him to live the weeks that remain and not just endure them. The experience of the patient extends to the family and will leave its mark on their memories of this period. Someone who is seriously ill, and his family, hope for the best medical and nursing care available and the patient needs these in order to control multiple symptoms. If this can be done, the patient's horizon widens, he and his family feel secure and acquire a certain freedom. With the help of this security and freedom however fragile they may be, patient and family can live and suffer together through a period of their history as individuals and as a family. How does one evaluate the quality of this life? What criteria does one apply in evaluation? Can one use the values which were important to a patient when he was in good health? What criteria does a person use in judging whether the quality of his life is good or bad at the moment? The fact remains that it is perfectly possible to evaluate the control of physical and even of psychosocial symptoms. But towards the end of life the importance which the patient attaches to meaning and to a sense of fulfillment is a challenge for those who want to measure his quality of life--and maybe even their own.