الفهرس 
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Abstract
SUMMARY
Worldwide, we are entering the era of the “graying of populations”. The
elderly in Egypt constitute ٧٫٣ % of society, and this group is growing as
life expectancy increases. With this phenomenon, there is, and will
continue to be an increased prevalence of terminal diseases and an
increased need for palliative care.
Death is a normal component of the human life cycle. It is an inevitable
event. Unfortunately, physicians regard death as an enemy which should
be fought aggressively with every possible weapon. This obsession with
the quantity rather than the quality of life can have a negative impact on
the patient.
Usually, care of the terminally ill patient centers on the disease and the
patient as a whole person is neglected. We should focus on improving the
patient’s quality of life rather than the quantity of life. Palliative care is an
approach that improves the quality of life of patients and their families
facing the problem associated with life-threatening illness, through the
prevention and relief of suffering by means of early identification,
assessment and treatment of pain and other problems, physical,
psychosocial and spiritual.
Family physicians participate in the family’s life, knowing patients
intimately over time, sharing their trust, respect and friendship.
Therefore, they are an integral part of the family and will practice some
form of end of life care. Because of the close relationship that family
physicians have with their patients, they are in a unique position to
provide end-of-life care.
It is not surprising that seeing a member of this family dying will be a
great load on the physician. The physician will feel helpless and
uncomfortable. This will eventually lead to withdrawal from the patient
leaving the patient to face suffering and death by him/herself. Patients
particularly dread being abandoned by their physicians in the face of
death. The patient’s fear of the unknown is better dealt with when it can
be shared with a caring physician who provides support, encouragement
and realistic hope. During terminal illness, it is essential that the family
physician would maintain the warm and caring relationship with the
patient and, through the strength of the doctor-patient bond, provide the
medical, psychological and spiritual needs of the dying patient and his or
her family.
from the inception of their specialty, family physicians have appreciated
the role of the health care team. Nowhere is this more important than in
palliative care. Both specialist palliative care services and services
involved in the pre-palliative phase of a patient’s disease must accept
family physicians as an essential part of the care team. Maintaining clear
lines of communication between hospitals and family physicians is
important.
The acceptance of the integral role of palliative care in the management
of cancer, AIDS and other non-communicable and ultimately fatal
disorders, will enhance its overall understanding and support by the
community, political leaders, and health professionals alike.
Family physicians should continue to stay current and competent in
knowledge and skills in the areas of palliative medicine. Short courses,
easy access to clinical training, updated guidelines for palliative care and
easy access to specialists in teaching centers should be an essential part of
their curriculum.
Palliative care should be a rewarding part of general practice, and indeed
the skills of good palliative care closely mirror those of good general
practice care.