End-of-life anguish: Aminoff suffering syndrome and relief of suffering units.
Aminoff suffering syndrome (ASS) in end-of-life is the new proposed term for a pathological symptomatology and entity that is characterized by a high (MSSE) scale score, <6 months survival, irreversible and intractable aggravation of suffering and medical condition until demise. Aminoff Suffering Syndrome was proposed as the key criterion for enrolling end-stage disease and dying patients to a Relief of Suffering Units. Based on clinical experience, the following items were included in the MSSE: Not calm, screams, pain, decubitus ulcers, malnutrition, eating disorders, invasive action, unstable medical condition, suffering according to medical opinion, and suffering according to family opinion. The results of clinical experience with this scale were presented at world and regional congresses in Berlin (1999), Jerusalem (2000), Vancouver (2001), Stockholm (2002), Tokyo (2003), Las Vegas (2004), Rio-de-Janeiro (2005), Madrid (2006), Saint-Petersburg (2007), Trondheim (2008), Paris (2009), Honolulu (2010), Athens (2011) and in Copenhagen (2012) and now in Seoul (2013). This paper proffers a new, alternative approach and setting for terminal and dying patients with ASS that could pertain to the Israeli setting, and could possibly also be applicable in other countries. Short hospitalization periods of approximately 1 month, and treatment in Relief of Suffering Units may be a new, palliative approach and present a possible solution for coping with the horrendous burden of the anguish of terminal and dying patients, their families, and the medical and nursing staff. Relief of suffering units should be part of intensive care units of any hospital department.