David Hui1. 1. Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Abstract
PURPOSE OF REVIEW: Death is a certainty in life. Yet, the timing of death is often uncertain. When death occurs suddenly and earlier than anticipated, it is considered as an unexpected death. In this article, we shall discuss when is death expected and unexpected, and review the frequency, impact, causes, and approach to unexpected death in the palliative care setting. RECENT FINDINGS: Even in the palliative care setting in which death is relatively common, up to 5% of deaths in hospice and 10% of deaths in palliative care units were considered to be unexpected. Unexpected death has significant impact on care, including unrealized dreams and unfinished business among patients, a sense of uneasiness and complicated bereavement among caregivers, and uncertainty in decision making among healthcare providers. Clinicians may minimize the impact of unexpected events by improving their accuracy of prognostication, communicating the uncertainty with patients and families, and helping them to expect the unexpected by actively planning ahead. Furthermore, because of the emotional impact of unexpected death on bereaved caregivers, clinicians should provide close monitoring and offer prompt treatment for complicated grief. SUMMARY: Further research is needed to understand how we can better predict and address unexpected events.
PURPOSE OF REVIEW: Death is a certainty in life. Yet, the timing of death is often uncertain. When death occurs suddenly and earlier than anticipated, it is considered as an unexpected death. In this article, we shall discuss when is death expected and unexpected, and review the frequency, impact, causes, and approach to unexpected death in the palliative care setting. RECENT FINDINGS: Even in the palliative care setting in which death is relatively common, up to 5% of deaths in hospice and 10% of deaths in palliative care units were considered to be unexpected. Unexpected death has significant impact on care, including unrealized dreams and unfinished business among patients, a sense of uneasiness and complicated bereavement among caregivers, and uncertainty in decision making among healthcare providers. Clinicians may minimize the impact of unexpected events by improving their accuracy of prognostication, communicating the uncertainty with patients and families, and helping them to expect the unexpected by actively planning ahead. Furthermore, because of the emotional impact of unexpected death on bereaved caregivers, clinicians should provide close monitoring and offer prompt treatment for complicated grief. SUMMARY: Further research is needed to understand how we can better predict and address unexpected events.
Authors: S J Goodlin; Z Zhong; J Lynn; J M Teno; J P Fago; N Desbiens; A F Connors; N S Wenger; R S Phillips Journal: JAMA Date: 1999 Dec 22-29 Impact factor: 56.272
Authors: David Hui; Kelly Kilgore; Linh Nguyen; Stacy Hall; Julieta Fajardo; Tonye P Cox-Miller; Shana L Palla; Wadih Rhondali; Jung Hun Kang; Sun Hyun Kim; Egidio Del Fabbro; Donna S Zhukovsky; Suresh Reddy; Ahmed Elsayem; Shalini Dalal; Rony Dev; Paul Walker; Sriram Yennu; Akhila Reddy; Eduardo Bruera Journal: Oncologist Date: 2011-10-05
Authors: Rachel A Rodenbach; Sally A Norton; Marsha N Wittink; Supriya Mohile; Holly G Prigerson; Paul R Duberstein; Ronald M Epstein Journal: Patient Educ Couns Date: 2018-12-12