ABSTRACT
This chapter focuses on ethics and communication skills station. It is important to both acknowledge the relatives' distress and find out why they are angry. Anticipatory grief is recognised as a cause of distress in the families of unwell patients. Recognition of a deteriorating patient is important for many reasons. First, it allows an appropriate treatment plan to be constructed. Additionally, it allows clinical teams to keep patients and families updated, and to help them plan for the future. Signs that a patient is in the last weeks of life include fatigue, decreased mobility, loss of independence in activities of daily living (ADLs), decreased appetite and impaired cognition. Signs that a patient is in the last days of life include decreased fluid intake, impaired swallowing, decreased conscious level and changes in breathing pattern. It is also important to be aware of recent developments in decisions about cardiopulmonary resuscitation.
