[{"Title":"Maumivu","UniqueID":"v714567_sw","Index":1.0,"Summary":"

Pain at the end of life is common, but pain management strategies can provide relief. The doctor’s choice of pain reliever (analgesic) depends largely on the intensity of the pain and its cause, which the doctor determines by talking with and observing the person. Aspirin, acetaminophen, or nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in relieving mild pain. However, many people need more powerful pain relievers such as opioids to treat moderate to severe pain. Opioids given by mouth, such as oxycodone, hydromorphone, morphine, methadone, and fentanyl, can relieve pain conveniently and effectively for many hours. If a person cannot take opioids by mouth, opioids are given via skin patch, injection under the skin or into a muscle, rectum, or continuous infusion into a vein.

","HeadType":"F_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[]},{"Title":"Kuishiwa na pumzi","UniqueID":"v714596_sw","Index":2.0,"Summary":"

Although particularly frightening to dying people, the sensation of shortness of breath and struggling to breathe (dyspnea) can usually be relieved. Various methods can usually ease dyspnea—for example, relieving fluid buildup, placing a chest tube, changing the person’s position, and providing supplemental oxygen. Inhaled albuterol or corticosteroids taken by mouth or by vein may relieve wheezing and lung inflammation. Opioids (such as morphine) may help to ensure comfort for people who have mild, persistent dyspnea, even if they do not have pain. Taking opioids at bedtime can promote comfortable sleep by preventing the person from waking up frequently, fighting to breathe. Benzodiazepines (such as lorazepam) often help relieve the anxiety caused by dyspnea. Other useful measures include providing a cool draft from an open window or fan and maintaining a calming presence.

","HeadType":"F_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[]},{"Title":"Matatizo ya Njia Utumbo","UniqueID":"v714607_sw","Index":3.0,"Summary":"

Digestive tract problems, including a dry mouth , nausea , constipation , difficulty swallowing , and loss of appetite , are common among people who are very sick. Some of these problems are caused by the disease. Others, such as constipation, can be side effects of medications.

","HeadType":"F_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[{"Title":"Mdomo mkavu","UniqueID":"v714612_sw","Index":1.0,"Summary":"

","HeadType":"H_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[]},{"Title":"Nausea and vomiting","UniqueID":"v714617_sw","Index":2.0,"Summary":"

","HeadType":"H_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[]},{"Title":"Kufunga choo","UniqueID":"v714624_sw","Index":3.0,"Summary":"

","HeadType":"H_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[]},{"Title":"Ugumu wa kumeza","UniqueID":"v714628_sw","Index":4.0,"Summary":"

","HeadType":"H_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[]},{"Title":"Kupoteza hamu ya kula","UniqueID":"v714632_sw","Index":5.0,"Summary":"

","HeadType":"H_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[]}]},{"Title":"Kushindwa kujizuia","UniqueID":"v714643_sw","Index":4.0,"Summary":"

Many dying people lose the ability to control bowel and bladder function (incontinence), either because of the disease or general weakness. Disposable adult diapers and attentive hygiene measures usually address the problem. Incontinent people should be kept as dry as possible, usually with frequent bedding and diaper changes. A catheter (a small tube placed into the bladder) increases the risk of a urinary tract infection and should be used only when bedding changes cause pain or when dying people or their family members strongly prefer it.

","HeadType":"F_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[]},{"Title":"Vidonda Vinavyotokana na Shinikizo","UniqueID":"v714654_sw","Index":5.0,"Summary":"

Dying people are susceptible to pressure sores (also called pressure ulcers or bedsores), which cause discomfort and can lead to infections. People who are very ill, move very little, are confined to bed, are incontinent, are poorly nourished, or sit much of the time are at greatest risk. Ordinary pressure on the skin from sitting or moving across sheets may tear or damage the skin. Every effort should be made to prevent pressure sores by protecting the skin, and promptly reporting reddened or broken skin to the doctor or nurse. Incontinent people should be kept as dry as possible. Position changes every 2 hours decrease the likelihood of pressure sores. A specialized mattress or continuously inflated air-suspension bed may also help.

","HeadType":"F_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[]},{"Title":"Uchovu","UniqueID":"v714662_sw","Index":6.0,"Summary":"

Most fatal illnesses cause fatigue. A person who is dying can try to save energy for activities that really matter. Often, making a trip to the doctor’s office or continuing an exercise that is no longer helping is not essential, especially if doing so saps the energy needed for more satisfying activities. Sometimes, stimulant medications help.

","HeadType":"F_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[]},{"Title":"Unyogovu na Wasiwasi","UniqueID":"v714669_sw","Index":7.0,"Summary":"

Feeling sad when contemplating the end of life is a natural response, but this sadness is not depression . People who are depressed usually lack interest in what is going on and may see only the bleak side of life or feel no emotions. Providing psychological support and allowing people to express concerns and feelings are usually the best approaches. A skilled social worker, doctor, nurse, or chaplain can help with these concerns. Dying people and their family should talk to the doctor about such feelings so that depression can be diagnosed and treated. Treatment (usually a combination of antidepressant medications and counseling) is often effective, even in the last weeks of life, because it improves the quality of the time remaining.

","HeadType":"F_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[]},{"Title":"Kuchanganyikiwa na Kupoteza fahamu","UniqueID":"v714681_sw","Index":8.0,"Summary":"

People who are very sick become confused easily. Confusion may be triggered by a medication, a minor infection, a chemical imbalance, or even a change in living arrangements. Reassurance and reorientation may relieve the confusion, but the doctor should evaluate the possibility of treatable causes. People who are very confused may need to be mildly sedated or constantly attended by a caregiver.

","HeadType":"F_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[]},{"Title":"Msongo wa mawazo","UniqueID":"v714697_sw","Index":9.0,"Summary":"

Some people approach death peacefully, but most dying people and their family members have stressful periods. Death is particularly stressful when interpersonal conflicts keep dying people and family members from sharing their last moments together in peace. Such conflicts can lead to excessive guilt or inability to grieve in survivors and can cause anguish in dying people. A family member who is caring for a dying relative at home may experience physical and emotional stress. Usually, stress in dying people and family members can be relieved somewhat with counseling or brief psychotherapy. Community services may be available to help relieve caregiver burden. If sedatives are prescribed for a caregiver, they usually should be taken sparingly and briefly.

","HeadType":"F_Head","SchemeItemProp":"itemprop=\"associatedAnatomy\" itemscope itemtype=\"http://schema.org/AnatomicalStructure\"","Children":[]},{"Title":"Udhaifu, Kichaa, na Magonjwa ya Nyuroni za Misuli","UniqueID":"v92049883_sw","Index":10.0,"Summary":"

People who are frail or have dementia or a neuromuscular diseases (for example, advanced Parkinson disease ) have a prolonged course with declining function and persistently unclear prognosis for survival. Family members often provide personal care for years, and the person may be unable to demonstrate appreciation for the assistance. The medical team works closely with caregivers to prevent falls, infections, and other risks, as well as to provide encouragement and support to the family and caregivers.

","HeadType":"F_Head","SchemeItemProp":"","Children":[]}]