Abstract

Patients with permanent disability, patients with chronic diseases such as obstructive lung disease, and the terminal patients all have in common the fact that their medical condition cannot usually be reversed. Such patients often engender a feeling of helplessness in the physician. Demoralization is characterized by hopelessness, loss of meaning, and existential distress. It is associated with chronic medical illness, disability, bodily disfigurement, fear of loss of dignity, social isolation, feelings of dependency on others, and the fear of being a burden. Psychiatric issues and their management associated with chronic lung disease and cance as well as with the dying patient, palliative care, and care of the care-givers are discussed.

Full Text
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