A Review of Clinical Signs and Symptoms of Imminent End-of-Life in Individuals With Advanced Illness

Abstract

Background: World population is not only aging but suffering from serious chronic illnesses, requiring an increasing need for end-of-life care. However, studies show that many healthcare providers involved in the care of dying patients sometimes express challenges in knowing when to stop non-beneficial investigations and futile treatments that tend to prolong undue suffering for the dying person. Objective: To evaluate the clinical signs and symptoms that show end-of-life is imminent in individuals with advanced illness. Design: Narrative review. Methods: Computerized databases, including PubMed, Embase, Medline,CINAHL, PsycInfo, and Google Scholar were searched from 1992 to 2022 for relevant original papers written in or translated into English language that investigated clinical signs and symptoms of imminent death in individuals with advanced illness. Results: 185 articles identified were carefully reviewed and only those that met the inclusion criteria were included for review. Conclusion: While it is often difficult to predict the timing of death, the ability of healthcare providers to recognize the clinical signs and symptoms of imminent death in terminally-ill individuals may lead to earlier anticipation of care needs and better planning to provide care that is tailored to individual’s needs, and ultimately results in better end-of-life care, as well as a better bereavement adjustment experience for the families.

Assessing the relationship between the distress levels in patients with irreversible terminal delirium and the good quality of death from the perspective of bereaved family.

“…In end-of-life patients, the exacerbation of nutritional depletion due to increased expenditure and decreased intake worsens malnutrition. This worsening of malnutrition further intensi es the nutritional depletion in patients, leading to a vicious cycle [35]. Considering the close relationship between nutritional de ciency and good quality of life, the importance of addressing nutritional needs in end-of-life care to improve patient outcomes is underscored.…”