By definition, palliative care is concerned with the physical, psychosocial and spiritual well being in progressive and usually non-curable disease. With growing life expectancy and the increasingly successful management of cardiovascular disease, the leading cause of mortality in Western countries will soon be from malignant disease. This will pose increasing demands on palliative care services, such as hospices; already, there are now over 3600 such institutions in North America. Their focus should be optimizing the quality of life remaining to the patients and support for their families. Nevertheless, care offered to individuals shortly before their death is often a neglected subject and there is very little guidance on the best management of pain, symptoms and the emotional needs during the last days of cancer patients.
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