Korean J Hosp Palliat Care.  2020 Sep;23(3):103-113. 10.14475/kjhpc.2020.23.3.103.

Clinical Practice Guideline for Care in the Last Days of Life

Affiliations
  • 1Department of Family Medicine, Konkuk University School of Medicine, Seoul, Korea
  • 2National Hospice Center, National Cancer Center, Goyang, Korea
  • 3Department of Family Medicine, International St. Mary’s Hospital College of Medicine, Catholic Kwandong University, Incheon, Korea
  • 4Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea
  • 5Maumtodac Psychiatric Clinic, Ansan, Korea
  • 6Department of Internal Medicine, Seoul Paik Hospital, Inje University, Seoul, Korea
  • 7Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
  • 8Hospice & Palliative Care Unit, The Catholic University of Korea, Seoul St. Mary’s Hospital, Korea
  • 9Department of Family Medicine, VHS Medical Center, Korea
  • 10Department of Anesthesiology and Pain Medicine, Seoul National University School of Medicine, Seoul, Korea
  • 11Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
  • 12Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
  • 13Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 14Department of Family Medicine, Korea University, College of Medicine, Seoul, Korea
  • 15Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
  • 16Hospice & Palliative Care Center, Korea University Guro Hospital, Seoul, Korea
  • 17Department of Hematology and Oncology, Ulsan University College of Medicine, Ulsan University Hospital, Ulsan, Korea
  • 18Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
  • 19Department of Internal Medicine, Anyang Sam Hospital, Anyang, Korea
  • 20Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

Abstract

A clinical practice guideline for patients in the dying process in general wards and their families, developed through an evidence-based process, is presented herein. The purpose of this guideline is to enable a peaceful death based on an understanding of suitable management of patients’ physical and mental symptoms, psychological support, appropriate deci-sion-making, family care, and clearly-defined team roles. Although there are limits to the available evidence regarding medical issues in patients facing death, the final recommendations were determined from expert advice and feedback, considering values and preferences related to medical treatment, benefits and harms, and applicability in the real world. This guideline should be applied in a way that takes into account specific health care environments, including the resources of medical staff and differences in the available resources of each institution. This guideline can be used by all medical institutions in South Korea.

Keyword

Terminal care; Symptom assessment; Communication; Decision making; Education
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