ABSTRACT
The boundaries between the two phases of care, active and palliative, are blurred, and a model of care based on respect for patient autonomy should ensure that the timing of the switch from curative to palliative care is appropriate. Research among individuals dying from heart failure has shown a wide range of symptoms, which are often distressing and last more than six months. Qualitative research among affected patients suggests that there is limited public understanding of heart failure. Research indicates that those patients with end-stage Chronic obstructive pulmonary disease have a significantly impaired quality of life, perhaps worse than that of many patients with lung cancer. Patients may become depressed because of delays or difficulties in making a diagnosis, or due to having an incurable illness with a prolonged course and multiple troublesome symptoms. Some authorities have pointed out that patients with advanced illness who stop drinking may not need artificial feeding or rehydration.
