25 A WHO guide for planners, implementers and managers
Dying patients When no further disease-modifying treatment is available or desired by the patient, the sole goal of care
may be comfort and maximizing the quality of life. Preventing and relieving the suffering of patients dying
at home is an essential task for primary care providers. Provision should be made for family members to
be present as appropriate. The prognostic understanding of the patient or family should be gently explored
and corrected as needed and as culturally appropriate. It should be explained that care to maximize comfort
is the best that medicine can offer under the circumstances. It should be made clear that there is never an
intention to hasten death but simply to provide whatever treatment is necessary to achieve an adequate
level of comfort for the patient in the context of the patient’s values. Aggressive efforts must be made to
relieve pain and other symptoms. Patients capable of preparing a simple legacy for their children or other
family members, such as a letter or memory box, should be given this opportunity. Local volunteer spiritual
supporters should be sought to provide culturally appropriate spiritual support if requested by the patient or
family. Bereavement support should also be made accessible
(51). This may consist of bereavement support
groups led by adequately trained personnel. Some interventions can be provided safely and effectively by
CHWs with basic training
(50).
27 A WHO guide for planners, implementers and managers
29 A WHO guide for planners, implementers and managers
