THE DIFFERENT SHADES OF CARE AND ITS IMPACT - A CASE REPORT

Introduction: The latest evidence shows that the holistic approach of patients at end of life increases their quality of life and probably their survival time. This case report intends to reflect about this phenomenon and its implications. Methods: Data collection of clinical process and literature review.  Results: An autonomous woman lived alone in social housing and was visited by her Family Physician (FP). She used to receive the FP with a challenging cheeky grin, in a small luminous airy house, animated by parakeet's chants. In 2011, with 87 years, she suffered a stroke that left her aphasic and totally dependent; she was taken to her daughter's house, who became her main caregiver. During the FP house visits she was very plaintive, with little social interaction, bedridden in a small, dark, silent, impersonal room and could barely be touched, due to the pain. Procedures and medication were done, with no visible effect. In 2012 she was moved to her son's residence. Here, she was progressively more serene, in a luminous, airy room, delighted with a parakeet's chant, a wind vane and stimuli from her new caregivers. All the painkillers were slowly removed. In the last house visit she received the FP with the same challenging cheeky grin. Conclusion: The care given to people with chronic incurable illnesses depends on the dyad patient/doctor and must be adjusted to the needs of the patient. The primordial goal is the comfort, quality of life and preservation of the person's dignity and interaction with significant people.