A family member who is caring for a dying patient at home may also experience physical and emotional stress. Usually, stress in patients and families is best treated with compassion, information, counseling, and even brief psychotherapy. Sedatives should be used sparingly and briefly. When a spouse dies, the survivor may be overwhelmed by making decisions about legal or financial matters or managing the household. With an elderly couple, the death of one partner may reveal cognitive impairment in the survivor for which the deceased spouse had compensated.
Stress is greater if no support is extended by friends or other family members.
Physicians should identify such high-risk situations so they can mobilize the resources needed to prevent undue suffering and dysfunction. Effective care for the dying usually involves a team, because no one caregiver can provide 24-h availability and several disciplines supply the needed skills and perspectives. Palliative care or hospice teams anticipate potential problems and make appropriate arrangements, such as obtaining supplies or opioids in an emergency. With death impending, an experienced person can comfort the family and may prevent an inappropriate call to the emergency medical system. Dying patients often have spiritual needs that should be recognized, acknowledged, and addressed.