Clinical Pearls

Facilitating Communication and Comfort at the End of Life

Teresa L. Deshields, PhD ABPP, and Jane E. Loitman, MD MBA FAAHPM

Mr. Z. is in the intensive care unit receiving clinician-activated boluses of hydromorphone for prostate cancer, metastatic to the bone. He is anxiously curled up, and the medication seems to have no effect. The boluses are stopped when the chaplain enters his room and the two are left alone. Twenty minutes later, Mr. Z. is relaxed, and his pain is better controlled.