Complexities in caregiving at the end of life

Faced with the inevitability of death, we all wish for good caregiving during the final stage of our lives. A new study from Karolinska Institutet and Umeå University shows that non-pharmacological caregiving at the end of life in specialized palliative care is not as basic as one might believe but is based on complex professional decisions that weave physical, psychosocial and existential dimensions into a functional whole. The researchers have found that particularly important aspects of palliative care are an aesthetically pleasing, safe and comfortable environment, bodily care and from another person and dying-related rituals. "To be sure, palliative care is all about satisfying fundamental human needs, but what we found in our study was that it entails so much more than one might at first assume," says Olav Lindqvist, researcher at the Medical Management Centre at Karolinska Institutet. "If we are to further develop palliative care, we must learn more about this type of daily caregiving and tease out its nuances." The study, which is published in PLoS Medicine, is part of a recently concluded three-year international project called OPCARE9, which was financed through the EUs Seventh Framework Programme. Its aim was to identify variations in non-pharmacological activities carried out as part of specialised palliative caregiving and to answer the question: What do caregivers actually do during the final days of a patient's life apart from administer drugs? The study included sixteen palliative outpatient and inpatient clinics in nine countries.