1. Therapeutic Approach to the Patient with a Life-Threatening Illness
ICBS 120
Chapter 6

2. What is a Life-Threatening Illness?
Words that may be used:
Terminal; believed to remove any hope from the situation.
Life-threatening for one person, may not be for another.
Life-threatening is used to imply life may be shortened.
Death that is imminent or a serious illness.

3. Cultural Influences
Defined: culture is how we live our lives, how we think, how we speak, and how we behave.
In some cultures, pain is to be endured quietly and can result in stress.
The strongest influence in managing any life-threatening illness is the family and those closest to the patient.

4. Choices in Life-Threatening Illness
Main Reason for discussing patient’s needs:
Give the patient the power in dealing with the illness.
Alternative methods of treatment should be discussed with patient as should pain management and various treatment methods..
A durable power of attorney for healthcare and/or a living will or physician’s directive.
It is NOT appropriate to discuss planning for a funeral.

5. Choices in Life-Threatening Illness Cont’d
Finances are to be considered.
Emotional needs of the patient and family members are important as is their support.

6. Range of Psychological Suffering
Range can be from mild to extensive symptoms of:
Distress
Anxiety
Depression
Denial
Numbness
Symptoms can be:
Tension, tachycardia, agitation, insomnia,
anorexia and panic attacks

7. Patients with HIV/AIDS
Tend to live longer with various treatments but their immune system is compromised.
Experience guilt based on past behavior.
May be estranged from their family.
Experience additional stress/strain.

8. Patients with Cancer Three most likely treatmetns for Cancer: Surgery
Radiation
Chemotherapy
NOTE: Sometimes it takes a
combination of all three.

9. ESRD (End-Stage Renal Disease)
Defined: When the kidneys fail completely and
patients cannot live long unless they receive
dialysis (replacing the main function of the
kidney such as filtering) or a transplant.

10. ESRD (End-Stage Renal Disease) Symptoms
Mild to severe itching
Mild confusion or disorientation
Hallucinations
Agitation
Decrease in appetite
Rapid, shallow breathing
Edema or swelling of the body
Loss of energy and sleep, lethargic.

11. Stages of Grief
.Denial
Anger
Bargaining
Depression
Acceptance