       Document 0257
 DOCN  M9590257
 TI    Palliative care of AIDS: the last month of life.
 DT    9509
 AU    Malcolm JA; Dobson PM; Nineways Specialist Clinic, Broadmeadow NSW.
 SO    Annu Conf Australas Soc HIV Med. 1994 Nov 3-6;6:266 (unnumbered poster).
       Unique Identifier : AIDSLINE ASHM6/95291842
 AB    We reviewed clinical records of 50 men who died of AIDS in the Hunter
       Region, NSW, between 1988-1992. Mean age at death was 37 years (range
       23-70). The most common principal cause of death was Cytomegalovirus
       infection (22%) with CMV retinitis in five cases. Other major causes
       were cerebral lymphoma (14%) and toxoplasmosis (10%). Other potentially
       fatal conditions were commonly also present and contributed to symptoms.
       Distressing symptoms included pain, dyspnoea, diarrhoea, fitting,
       confusion or dementia, difficulty in eating or swallowing and loss of
       vision (in 10%). Dehydration, malnutrition, peripheral neuropathy and
       herpetic lesions were important problems. Management in the last month
       of life was often directed to symptom palliation, which could require
       intravenous therapy and oxygen. Infections (other than HIV) capable of
       transmission to carers were common. Almost half the subjects lived with
       their family of origin in the months before death, 12% lived alone and
       22% with their partner. In some cases a partner or other family member
       also had HIV infection. Only 54% lived in the area now served by a Level
       6 palliative care unit. 20% lived in a flat or hostel and 12% on rural
       properties. Death occurred in a hospital or other institution in all but
       four cases, and often was not expected until shortly before it occurred.
       These observations have implications for the palliative care of
       late-stage HIV disease, particularly in country areas.
 DE    Acquired Immunodeficiency Syndrome/MORTALITY/*THERAPY  Adult  Aged
       AIDS-Related Opportunistic Infections/MORTALITY/THERAPY  Cause of Death
       Home Nursing  Human  Lymphoma, AIDS-Related/MORTALITY/THERAPY  Male
       Middle Age  Palliative Treatment/*METHODS  Patient Admission  Terminal
       Care/*METHODS  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

