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When to Transition from Curative Treatment to Palliative Care: Difficult Decisions and Quality of Life in Terminal Illness

A middle-aged Hispanic doctor with a kind expression holds the hand of an elderly patient in a naturally lit hospital room. This scene reflects empathy and human connection, emphasizing the importance of quality of life in palliative care and decision-making for patients with terminal illness.

The transition from curative treatment to palliative care is one of the most complex decisions we face in medical practice. This change not only involves an adjustment in therapeutic focus but also requires a profound consideration of the patient's quality of life. In the context of a terminal illness, decision-making must be informed, compassionate, and patient-centered, ensuring that the patient's wishes and needs are respected.

Diving Deeper into the Transition

The appropriate time to consider the shift towards palliative care can vary significantly among patients and depends on multiple factors, including disease progression, treatment response, and the personal preferences of the patient and their family. A study on end-of-life care in nursing homes highlights the importance of a patient-centered environment, where continuity of care is promoted, and the patient's wishes are respected at the end of life [1].

In cases of conditions such as stroke, integrating palliative care from the acute stages can improve outcomes for patients and their families, although it often faces challenges in communication and decision-making [2]. The lack of access to palliative care throughout the disease trajectory underscores the need for models that integrate these services more effectively.

Furthermore, in the context of oncology, the transition to palliative treatment may be influenced by clinical, interpersonal, and healthcare system factors. Physicians' perceptions of the expected quality of life for the patient and communication barriers can significantly affect this decision [3].

Conclusions

The decision to move from curative treatment to palliative care is a complex process that requires careful evaluation of the patient's quality of life and clear communication among the medical team, the patient, and their family. Early integration of palliative care can provide additional support, improving symptom management and facilitating advance care planning [4]. Ultimately, the goal is to ensure that the care provided aligns with the patient's wishes, promoting their well-being and dignity in the final stages of life.

References


Created 13/1/2025