Leaders in end-of-life care recently developed a set of precepts for palliative care:

The following two case reports illustrate the acute and chronic nature of palliative care in cancer nursing. They also demonstrate that relationships, trust, and continuity are important, and that a full and “human” assessment of the patient and family is critical if their needs are to be met.

CASE 1

RG is a 45-year-old man who was diagnosed with advanced gastric cancer one month prior to admission to the cancer center. He is divorced, has two adult daughters, three grandchildren, and lives with his fiancée who is 5 months pregnant. He has a recent history of drug abuse including opioids and crack cocaine, and had been in a methadone maintenance program. On admission to the cancer center he was cachectic, had severe abdominal pain, gross ascites, early satiation, nausea and vomiting, insomnia, fatigue, and general irritability.

RG was not a surgical candidate but was offered chemotherapy, which he accepted. During the 2-week hospital admission he had his ascites drained, a PEG feeding tube inserted, a PORT placed for central venous access, and was started on a parenteral infusion of morphine sulfate for pain.