Care of dying patients

Caring for a patient during the last phase of his or her life is a demanding obligation and a privilege for the physician. The physician has the responsibility to be knowledgeable about the natural history of disease processes and the body's changing physiology. The physician must be thorough in the evaluation of the patient, not only in the physical and laboratory examinations, but also by striving to understand the patient psychologically, socially, and philosophically. The caregivers must be open, honest, and compassionate in dealing with the patient and family. The goals are to relieve suffering and to restore function to the fullest attainable extent, so that the patient can live his or her life in the most meaningful way. This requires frequent reevaluation of the patient and the judicious use of appropriate diagnostic and therapeutic modalities. As much as possible, the patient should be involved in the decision making process. The patient should be encouraged to make his or her wishes known before becoming unable to communicate, and should designate someone to act on his or her behalf. The grieving process often starts before death and may continue for many months. Plans should be made to assist the patient and the family in dealing with grief.     

Care of patients nearing death: another view

A person with an advanced, progressive, ultimately fatal illness faces multifaceted suffering. It is difficult to be sick. Uncontrollable deterioration of one's body can be horrible. Many people detest seeking help from others, yet nearly all want companionship in the face of death. The choice is hard, between certain death, even if it is promised to be comfortable and dignified, and hope, even if it is a burdensome treatment that offers small chance of limited benefit. Dying patients are often expected to make such painful choices. Perhaps what is most painful is to be dying. A person whose near future necessarily contains all this will often need a trusted, unhurried companion, acting with gentle advocacy and humility. This paper offers perspective and suggestions to such companions/advocates.     

Care of patients with Alzheimer's disease and their families

Although the medical management options in Alzheimer's disease are limited, physicians have a central role in addressing multiple associated care needs of these patients and their families. These needs change according to different stages of the disease. Sensitive disclosure of diagnosis and providing education, guidance, and appropriate referrals to community resources are essential components to an effective care plan. By making use of a multidisciplinary network of care providers, the physician can ensure the family of proactive management throughout the course of the disease.     

Care of tuberculosis patients in the times of COVID-19

Globally during this time of Covid-19 pandemic health care services are overhelmed and it has negative impact on other diseases like Tuberculosis (TB). High TB burden countries like India despite being faced by several other problems in present times, is continuously trying to provide uninterrupted services to TB patients through the national programs. In this general perspective we have shared our opinion on problems faced by TB patients in the times of covid-19     

致心律失常性右心室心肌病患儿14例护理体会

目的总结14例致心律失常性右心室心肌病患儿的护理体会。方法评估患儿危险因素;注意病情观察,持续24 h心电监测,严密观察心律、心率及心电图变化,发现异常及时报告医生处理;遵医嘱正确使用抗心律失常药物及扩血管药物,做好药物的观察及护理;重视健康指导使患儿得到正规治疗并按时复诊。结果 14例经治疗后心律失常症状改善出院。结论做好致心律失常性右心室心肌病患儿的护理工作是其康复的有利保障。