Utility of the care

Chronic or degenerative diseases, for example, can't be solved with an admission to the ICU: when dealing with the burden of a difficult therapeutic path is not paid off with recovery, intensive treatment causes only useless suffering.

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As for the hospitalization, it's necessary to weight up benefits and risks before every therapeutic choice: intensive treatments, beyond potential benefits, also have serious side effects that cannot be tolerated by all the patients.

In more severe cases, when the clinical situation is fatally compromised, the best choice for the patients – even if it's difficult for physicians and relatives to accept it – is not to carry on invasive treatments and even suspend some therapies due to the fact that no more real possibilities of improving exist.

These are tragic moments; the decision to suspend treatments is always truly difficult. In these cases it is necessary to inform the relatives about the real conditions of their beloved and it is fair to involve them in this decisional process, so that there won't be any further senses of guiltiness or fear that "not all possible was performed".

Sometimes, doing "all the possible" is not the best thing for the patient; treatments have to be proportional to the real possibilities of recovery. It is essential to combine hope with awareness: every patient require an individualized approach to their actual necessities, and gets it to obtain the best possible state of health.

As the patients can't choose on their own because of the diseases or the treatments (for example, sedative drugs), it is necessary that care givers and relatives find – together –the best balance between the real hope of improving and the dangers and the suffering coming from the prosecution of useless treatments. This doesn't mean suspending all the treatments nor abandon the patient, but a change in the target: not the recovery anymore, but the best wellness compatible with that disease.

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