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J Korean Med Assoc > Volume 52(7); 2009 > Article
Kim and Choi: The Last Hours of Living: Practical Advice for Clinicians


Caring for a patient dying is a hardship not only to the health care professionals, but also to the direct family members. Everyone wants to die in peace. However, inevitable problems accompanied by, pain, dyspnea, moist breathing, nausea and vomiting, restlessness jerking and twitching were commonly noted in the last phase of life. Terminal patients also experience increasing weakness and immobility, loss of interest in food and drink, difficulty in swallowing, and drowsiness during the last hours of life. Control of symptoms and family support are extremely important, and the actual nature of the primary illness takes less importance. This is a time when levels of anxiety, stress, and emotion can be high to patients, families, and other caregivers. Thus, it is important for the healthcare team to adopt sensitive and systematic approach to patients including documentation and communication of end-of-life issues. Hospice is the most ideal program for this purpose.


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Table 1
Pharmacologic management of common manifestations in the late hours of living

*Parenteral administration is inappropriate, because of its long action time.

also useful for dyspnea with anxiety/panic

lack of well established evidence


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