dying, care of thePhysical and psy-
chological care with the aim of making
the final period of a dying person’s life as
free from pain, discomfort, and emoti-
onal distress as possible. Carers may
include doctors, nurses, other medical
professionals, counsellors, social work-
ers, clergy, family, and friends.
Pain can be relieved by regular low
doses of analgesic drugs. Opioid anal-
gesics, such as morphine, may be given
if pain is severe. Other methods of pain
relief include nerve blocks, cordotomy,
and TENS. Nausea and vomiting may be
controlled by drugs. Constipation can
be treated with laxatives. Breathlessness
is another common problem in the dying
and may be relieved by morphine.
Towards the end, the dying person
may be restless and may suffer from
breathing difficulty due to heart failure
or pneumonia. These symptoms can be
relieved by drugs and by placing the
patient in a more comfortable position.
Emotional care is as important as the
relief of physical symptoms. Many dying
people feel angry or depressed and feel-
ings of guilt or regret are common
responses. Loving, caring support from
family, friends, and others is important.
Many terminally ill people prefer to
die at home. Few terminally ill patients
require complicated nursing for a pro-
longed period. Care in a hospice may be
offered. Hospices are small units that
have been established specifically to
care for the dying and their families.
dys-A prefix meaning abnormal, diffi-
cult, painful, or faulty, as in dysuria
(pain on passing urine).
dysarthriaA speech disordercaused by
disease or damage to the physical ap-
paratus of speech or to nerves controlling
this apparatus. Affected people can for-
mulate, select, and write out words and
sentences grammatically; the problem is
with vocal expression only. Dysarthria
is common in many degenerative neu-
rological conditions, such as multiple
sclerosisand Parkinson’s disease. Dys-
arthria may result from a stroke, brain
tumour, or an isolated defect or damage
to a particular nerve. Structural defects
of the mouth, as occur in cleft lip and
palate, can also cause dysarthria.Drug or surgical treatment of the under-
lying disease or structural defect may
improve the ability to speak clearly.
Speech therapy is useful.
dyscalculiaA disorder in which there is
difficulty in solving mathematical prob-
lems. (See also learning difficulties.)
dyschondroplasiaA rare disorder, also
called multiple enchondromatosis, that
is present from birth and characterized
by the presence of multiple tumours of
cartilaginous tissue within the bones
of a limb. It is caused by a failure of nor-
mal bone development from cartilage.
The bones are shortened, resulting in
deformity. Rarely, a tumour may become
cancerous (see chondrosarcoma).
dysenteryAn intestinal infection, caus-
ing diarrhoea (often with blood, pus,
and mucus) and abdominal pain. There
are 2 distinct forms: shigellosis, due to
shigella bacteria; and amoebic dysen-
tery, caused by the protozoan parasite
ENTAMOEBA HISTOLYTICA. The main risk
with dysentery is dehydration.
dysgraphiaProblems with writing (see
learning difficulties).
dyskinesiaAbnormal muscular move-
ments. Uncontrollable twitching, jerking,
or writhing movements cannot be sup-
pressed and may affect control of
voluntary movements. The disorder may
involve the whole body or be restricted
to a group of muscles. Types of dyskine-
sia include chorea(jerking movements),
athetosis(writhing), choreoathetosis(a
combined form), myoclonus (muscle
spasms), tics(repetitive fidgets), and
tremors. Dyskinesia may result from
brain damage at birth or may be a side
effect of certain drugs (see tardive dyski-
nesia), which often disappears when the
drug is stopped. Otherwise, dyskinesia is
difficult to treat. (See also parkinsonism.)
dyslexiaA reading disability character-
ized by difficulty in coping with written
symbols. It is more common in males,
and evidence suggests that a specific,
sometimes inherited, neurological dis-
order underlies true dyslexia. A child
with dyslexia has normal intelligence.
Thus, his or her attainment of reading
skills lags far behind other scholastic
abilities. While many young children
tend to reverse letters and words (forDYING, CARE OF THE DYSLEXIAD