Terminalfasen

Terminalfasen is the final phase of a progressive, incurable illness in which life expectancy is limited and the focus of care shifts from curative treatment to comfort and quality of life. The length of this phase varies widely, from days to weeks or, in some cases, a few months, depending on the underlying condition and individual factors.

Clinical features commonly seen in terminalfasen include progressive functional decline, reduced ability to eat and drink, alterations in consciousness or alertness, and changes in sleep-wake patterns. Other frequent symptoms are pain, dyspnea, fatigue, nausea, constipation, restlessness, and delirium. Psychological and social aspects, such as anxiety, distress for relatives, and spiritual concerns, may also be prominent. Symptom management in this phase emphasizes comfort, dignity, and relief of suffering, often using opioids for pain or breathlessness, antiemetics, laxatives, and careful symptom assessment.

Care approaches emphasize patient-centered goals and family support. The primary aim is to maximize comfort and maintain dignity, with decisions about treatments aligned with the patient’s preferences and values. This may involve advance care planning, goals-of-care discussions, and, when appropriate, do-not-resuscitate orders or withdrawal of life-sustaining treatments. Care can be provided at home, in hospice, or in hospital settings, with interdisciplinary teams addressing medical, psychological, and social needs.

Prognosis in terminalfasen is uncertain and individual. It is determined by the underlying disease trajectory, comorbidities, and overall functional status. Awareness and communication about prognosis, expectations, and care wishes remain essential throughout this phase.