Editing Terminal illness (section)

{{short description|Incurable fatal disease}}
{{about|fatal diseases|the alternative definition of eyestrain|computer vision syndrome|other uses|Terminal (disambiguation){{!}}Terminal}}
{{Use dmy dates|date=September 2020}}

'''Terminal illness''' or '''end-stage disease''' is a [[disease]] that cannot be [[cure]]d or adequately treated and is expected to result in the [[death]] of the patient. This term is more commonly used for progressive diseases such as [[cancer]], rather than fatal injury. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a '''terminal patient''', '''terminally ill''' or simply as being '''terminal'''. There is no standardized [[life expectancy]] for a patient to be considered terminal, although it is generally months or less.  An illness which is lifelong but not fatal is called a ''[[chronic condition]]''.

Terminal patients have options for disease management after diagnosis. Examples include [[Caregiver|caregiving]], continued treatment, [[Palliative care|palliative]] and [[hospice]] care, and [[Assisted suicide|physician-assisted suicide]]. Decisions regarding management are made by the patient and their family, although medical professionals may offer recommendations of services available to terminal patients.<ref name="Lima-2016a">{{Cite journal|last1=Lima|first1=Liliana De|last2=Pastrana|first2=Tania|year=2016|title=Opportunities for Palliative Care in Public Health|journal=Annual Review of Public Health|volume=37|issue=1|pages=357–374|doi=10.1146/annurev-publhealth-032315-021448|pmid=26989831|doi-access=free}}</ref><ref name="Hendry-2013">{{Cite journal|last1=Hendry|first1=Maggie|last2=Pasterfield|first2=Diana|last3=Lewis|first3=Ruth|last4=Carter|first4=Ben|last5=Hodgson|first5=Daniel|last6=Wilkinson|first6=Clare|date=2013-01-01|title=Why do we want the right to die? A systematic review of the international literature on the views of patients, carers and the public on assisted dying|journal=Palliative Medicine|volume=27|issue=1|pages=13–26|doi=10.1177/0269216312463623|pmid=23128904|s2cid=40591389|issn=0269-2163}}</ref>

Lifestyle after diagnosis varies depending on management decisions and the nature of the disease, and there may be restrictions depending on the condition of the patient. Terminal patients may experience depression or [[Death anxiety|anxiety associated with impending death]], and family and caregivers may struggle with psychological burdens. Psychotherapeutic interventions may alleviate some of these burdens, and is often incorporated into [[palliative care]].<ref name="Lima-2016a"/><ref name="Block-2006">{{Cite journal|last=Block|first=Susan D.|title=Psychological Issues in End-of-Life Care|journal=Journal of Palliative Medicine|volume=9|issue=3|pages=751–772|doi=10.1089/jpm.2006.9.751|pmid=16752981|year=2006}}</ref>

When terminal patients are aware of their impending deaths, they have time to prepare for care, such as [[Advance healthcare directive|advance directives]] and living wills, which have been shown to improve end-of-life care. While death cannot be avoided, patients can strive to die a death seen as good.<ref name="AHRQ-2017">{{Cite web|url=https://archive.ahrq.gov/research/findings/factsheets/aging/endliferia/endria.html|title=Advance Care Planning, Preferences for Care at the End of Life {{!}} AHRQ Archive|website=archive.ahrq.gov|access-date=2017-10-24}}</ref><ref name="Qaseem-2008">{{Cite journal|last1=Qaseem|first1=Amir|last2=Snow|first2=Vincenza|last3=Shekelle|first3=Paul|last4=Casey|first4=Donald E.|last5=Cross|first5=J. Thomas|last6=Owens|first6=Douglas K.|last7=Physicians*|first7=for the Clinical Efficacy Assessment Subcommittee of the American College of|date=2008-01-15|title=Evidence-Based Interventions to Improve the Palliative Care of Pain, Dyspnea, and Depression at the End of Life: A Clinical Practice Guideline from the American College of Physicians|journal=Annals of Internal Medicine|volume=148|issue=2|pages=141–6|doi=10.7326/0003-4819-148-2-200801150-00009|pmid=18195338|issn=0003-4819|doi-access=free}}</ref><ref name="Steinhauser-2000">{{Cite journal|last1=Steinhauser|first1=Karen E.|last2=Clipp|first2=Elizabeth C.|last3=McNeilly|first3=Maya|last4=Christakis|first4=Nicholas A.|last5=McIntyre|first5=Lauren M.|last6=Tulsky|first6=James A.|date=2000-05-16|title=In Search of a Good Death: Observations of Patients, Families, and Providers|journal=Annals of Internal Medicine|volume=132|issue=10|pages=825–32|doi=10.7326/0003-4819-132-10-200005160-00011|pmid=10819707|s2cid=14989020|issn=0003-4819}}</ref>  However, many healthcare providers are uncomfortable telling people or their families that they are dying.  To avoid uncomfortable conversations, they will withhold information and evade questions.<ref name=":0">{{Cite book |last=Reich |first=Barbara A. |url=https://books.google.com/books?id=Iq9hEAAAQBAJ&dq=%22life-limiting%22+%22euphemism%22&pg=PA109 |title=Intimations of Mortality: Medical Decision-Making at the End of Life |date=2022-03-17 |publisher=Cambridge University Press |isbn=978-1-108-80404-2 |pages=108–112 |language=en}}</ref>