Transitioning to End-of-Life Care

  • Lillie D. Shockney


Although more and more people in the USA diagnosed with cancer today are surviving their disease and its treatment, 595,690 people died of cancer in 2016 ( This is in part due to more individuals being diagnosed with cancer today, given that baby boomers have become senior citizens, increasing the denominator of the population today, which in turn increases the numerator among those diagnosed with some life-threatening form of cancer. Navigators must provide support across the continuum of care, including when the final outcome will be death instead of long-term survivorship as hoped. Patients dealing with advanced cancers require a strong advocate to represent them when they are not able to speak up for themselves. Misinformation and confusion remain about the benefits of palliative care and hospice, which can result in patients not getting the support they need physically and emotionally as they approach the end of life. All patients in such situations deserve and have the right to experience a good death. Nurse navigators have an instrumental role in patient advocacy, facilitating improved communication among the treatment team and the patient as well as their family caregivers, and promoting the utilization of palliative care early on and hospice care when the time is appropriate to make such a referral. Navigators savvy in navigating patients transitioning to end of life should take great pride in supporting such patients during the most sensitive, vulnerable, and profound time in their lives. This can all be accomplished by understanding the role hope plays in the patient’s care and helping the patient to transition through each phase of hope. There are also known barriers to such a transition, particularly when the transition should include implementation of certain resources like palliative care and hospice services. This chapter focuses on all of these issues, recognizing along this trajectory that navigation is a solution to prevention of these barriers, as well as an effective resource to ensure the patient has an advocate to speak on their behalf if they are unable to do so for themselves. The final outcome should be the orchestration of a good death for the patient, with their family caregivers well prepared for this loss. When patients are distressed that they will not “be here” to witness specific milestones that will happen in the future among their family members, especially young children, navigators can play an instrumental role in working with the patient to identify alternative methods to fulfill these hopes and life goals. Taking on such a role on behalf of the patient is one of the most profound ways to support a patient and help them transition as needed so they experience a peaceful, good death.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Johns Hopkins University School of MedicineBaltimoreUSA

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