RESUMO
One aspect of palliative medicine that has been underexplored is the perspective of veterans either facing critical life-limiting illness or at the end of life. The needs of veterans differ not only because military culture affects how veterans cope with their illness but also because exposure-related factors (combat and environmental) differ between military branches. In this paper, we describe two cases involving end-of-life care for veterans with combat trauma and describe individualized approaches to their care.
Assuntos
Distúrbios de Guerra/terapia , Epilepsia Pós-Traumática/terapia , Cuidados Paliativos na Terminalidade da Vida/normas , Medicina Militar/normas , Cuidados Paliativos/normas , Assistência Centrada no Paciente/normas , Veteranos , Idoso , Luto , Distúrbios de Guerra/mortalidade , Epilepsia Pós-Traumática/mortalidade , Evolução Fatal , Pesar , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Estados UnidosRESUMO
The mental and physical health of 146 Dutch males exposed to severe war stress during their young adulthood were examined in 1986-1987 when they were at ages 61 to 66 years. The veterans' data were compared with a randomly selected population-based sample of same-aged males. In 2005, 70% of the war stress veterans had died, and only 35% of the comparison group. The baseline quality of life was significantly poorer in the war stress veterans than in the comparison group. Baseline variables explained 42% of the increased risk of mortality among war stress veterans. Smoking was the largest single contributor to mortality.