At stage four, the disease is not curable and the body is not in a condition to tolerate any further treatment and the accompanied pain. At some point in time, the painful and the difficult decision to stop giving further treatment is considered. Mitigation of the hardships through palliative care rests in the hands of the nurses and caregivers. When the patient is in the terminal stage, the quality time spent by the near and dear ones with the patient and the spiritual support given to them are very important at the end of life care. The process needs little empathy on the part of the family and the society to overcome the barriers in giving the much-needed support. Andrew’s efforts in this direction indicate his love and affection towards his wife, and his understanding is also borne out of practical considerations.
Patient history: Clare .is a 65-year-old woman, with lung cancer, an eventually fatal condition. Clare suffers from breathlessness, cough and fatigue. She gets distressed by her inability to .‘catch her breath’. Sometimes she has trouble sleeping at night and is frequently sleepy during .the day. She doesn’t have many strategies to help her manage her symptoms.
The support in terms of physical, psychological, social, spiritual, and practical needs of patients and caregivers is essential for a peaceful end of life of the patient. Though there may be several approaches in dealing with a subject, as far as the end of life care is concerned, in the absence of complete cure beyond certain stage, the important issues are pain management, physical support in day to day activities, family support in overcoming the emotional distress and spiritual support aiming to prepare the patients to cope up with the anxiety and the emotional strain which is amply reflected in the statement of Clare “She .views her illness as a challenge as it impacts on what she can do and she doesn’t feel in control .of her life”.  .