Caregiver/End of Life

Significant distress is experienced by patients, families, and caregivers when a symptom or disorder, such as an agitated delirium, becomes an intractable, or a catastrophic event, such as irreversible stridor. When palliative sedation is indicated for these patients, midazolam is usually the preferred drug. In some cases, however, midazolam fails to provide adequate sedation. Two cases are presented to illustrate this phenomenon and explore the possible mechanisms underlying this lack of response. These mechanisms appear to be multifaceted...

Delirium is a complication related with the treatment and the evolution of cancer diseases. This disorder occurs more often among patients who are under treatment (chemo or radiotherapy) and among those who are terminally ill. Estimates of prevalence of delirium range from 4% to 40%. Delirium must be detected and treated as soon as possible because it is often associated with a poor prognosis of the cancer disease and with the development of an important distress of patients and their relatives. Delirium may have several underlying causes...