{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:32:54Z","timestamp":1785411174466,"version":"3.56.0"},"reference-count":11,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T00:00:00Z","timestamp":1713916800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Healthcare practitioners are regularly faced with treating patients at the end of their life, and this can be very daunting. This article hopes to help the practitioner have an approach to managing end-of-life care that makes it less distressing. The symptoms at the end-of-life include delirium and\/or agitation, breathing changes, skin changes, sleeping more, decrease in need for food and drink, incontinence, and increased secretions. These symptoms are discussed and practical ways of management are given. The article further discusses how to approach the difficult conversation with the family and gives guidance as to what needs to be discussed. A number of tips are discussed on how to prepare the family to handle a death at home. It is essential to look at coping mechanisms and selfcare for practitioners dealing with end-of-life care as the death of a patient not only affects the family but also the practitioner.<\/jats:p>","DOI":"10.4102\/safp.v66i1.5916","type":"journal-article","created":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T18:06:42Z","timestamp":1713982002000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["How to approach patients and families at the end of life"],"prefix":"10.4102","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7332-305X","authenticated-orcid":false,"given":"Maggie","family":"De Swardt","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03p74gp79","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2394-500X","authenticated-orcid":false,"given":"Rene","family":"Krause","sequence":"additional","affiliation":[{"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3221-8683","authenticated-orcid":false,"given":"Louis S.","family":"Jenkins","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2024,4,24]]},"reference":[{"key":"ref0","unstructured":"Association of Palliative Care Centres of South Africa [homepage on the Internet]. [cited 2024 Jan 24]. Available from: https:\/\/apcc.org.za"},{"key":"ref1","unstructured":"PALPRAC. A guide to caring for someone in their last days to hours of life [homepage on the Internet]. [cited 2024 Jan 24]. Available from: https:\/\/palprac.org\/wp-content\/uploads\/2020\/04\/PALPRAC-A-guide-to-caring-for-someone-who-is-in-their-last-days_hours-of-life-1.pdf"},{"key":"ref2","unstructured":"National Health System. What you can do to practically care for someone who is in their last days and hours of life [homepage on the Internet]. [cited 2024 Jan 24]. Available from: https:\/\/helixcentre.com\/_content-img\/projects\/eolc-toolkit\/Practical-Care-For-Dying-Person-Toolkit.pdf"},{"key":"ref3","unstructured":"Ethical Guidelines on Palliative Care. HPCSA Booklet 17 (2019) [homepage on the Internet]. [cited 2024 Mar 08]. Available from: https:\/\/www.hpcsa-blogs.co.za\/wp-content\/uploads\/2019\/09\/HPCSA-Booklet-17-Ethics-Guidelines-on-Pallative-Care.pdf"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Cai J, Zhang L, Guerriere D, Coyte PC. Congruence between preferred and actual place of death for those in receipt of home-based palliative care. J Palliat Med. 2020;23(11):1460\u20131467. https:\/\/doi.org\/10.1089\/jpm.2019.0582","DOI":"10.1089\/jpm.2019.0582"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Roberts B, Robertson M, Ojukwu EI, Wu DS. Home based palliative care: Known benefits and future directions. Curr Geriatr Rep. 2021;10(4):141\u2013147. https:\/\/doi.org\/10.1007\/s13670-021-00372-8","DOI":"10.1007\/s13670-021-00372-8"},{"key":"ref6","unstructured":"Hospice Palliative Care Association of South Africa. Clinical Guidelines 2012 [homepage on the Internet]. [cited 2024 Jan 24]. Available from: https:\/\/apcc.org.za\/wp-content\/uploads\/2020\/04\/HPCA_Clinical_guidelines_2012-1.pdfAPCC"},{"key":"ref7","unstructured":"Hospice United Kingdom. What to expect when someone is in the last few days of life [homepage on the Internet]. [cited 2024 Jan 24]. Available from: https:\/\/www.hospiceuk.org\/information-and-support\/death-and-dying-what-expect\/last-few-days"},{"key":"ref8","unstructured":"Wilcock A, Howard P, Charlesworth S, editors. Palliative Care Formulary. London: Pharmaceutical Press; 2020."},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Rosenzweig MQ. Breaking bad news: A guide for effective and empathetic communication. Nurse Pract. 2012;37(2):1\u20134. https:\/\/doi.org\/10.1097\/01.NPR.0000408626.24599.9e","DOI":"10.1097\/01.NPR.0000408626.24599.9e"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES \u2013 A six-step protocol for delivering bad news: Application to the patient with cancer. 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