Integration of palliative care in chronic critical illness management

Judith E. Nelson, Aluko A. Hope

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Palliative care is an essential component of comprehensive care for all patients with chronic critical illness, including those receiving restorative or life-sustaining therapies. Core elements include alleviation of symptom distress, communication about care goals, alignment of treatment with the patient's values and preferences, transitional planning, and family support. Here we address strategies for assessment and management of symptoms, including pain, dyspnea, and depression, and for assisting patients to communicate while endotracheally intubated. We also discuss approaches to optimize communication among clinicians, patients, and families about care goals. Challenges for supporting families and planning for transitions between care settings are identified, while the value of interdisciplinary input is emphasized. We review "consultative" and "integrative" models for integrating palliative care and restorative critical care. Finally, we highlight key ethical issues that arise in the care of chronically critically ill patients and their families.

Original languageEnglish (US)
Pages (from-to)1004-1012
Number of pages9
JournalRespiratory Care
Volume57
Issue number6
DOIs
StatePublished - Jun 2012

Fingerprint

Palliative Care
Critical Illness
Chronic Disease
Family Planning Services
Communication
Symptom Assessment
Patient Preference
Critical Care
Ethics
Dyspnea
Patient Care
Depression
Pain
Therapeutics

Keywords

  • Communication
  • Intensive care
  • Mechanical ventilation
  • Palliative care

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Integration of palliative care in chronic critical illness management. / Nelson, Judith E.; Hope, Aluko A.

In: Respiratory Care, Vol. 57, No. 6, 06.2012, p. 1004-1012.

Research output: Contribution to journalArticle

@article{1418a9e7abe944858d8e8d63ff127c01,
title = "Integration of palliative care in chronic critical illness management",
abstract = "Palliative care is an essential component of comprehensive care for all patients with chronic critical illness, including those receiving restorative or life-sustaining therapies. Core elements include alleviation of symptom distress, communication about care goals, alignment of treatment with the patient's values and preferences, transitional planning, and family support. Here we address strategies for assessment and management of symptoms, including pain, dyspnea, and depression, and for assisting patients to communicate while endotracheally intubated. We also discuss approaches to optimize communication among clinicians, patients, and families about care goals. Challenges for supporting families and planning for transitions between care settings are identified, while the value of interdisciplinary input is emphasized. We review {"}consultative{"} and {"}integrative{"} models for integrating palliative care and restorative critical care. Finally, we highlight key ethical issues that arise in the care of chronically critically ill patients and their families.",
keywords = "Communication, Intensive care, Mechanical ventilation, Palliative care",
author = "Nelson, {Judith E.} and Hope, {Aluko A.}",
year = "2012",
month = "6",
doi = "10.4187/respcare.01624",
language = "English (US)",
volume = "57",
pages = "1004--1012",
journal = "Respiratory Care",
issn = "0020-1324",
publisher = "Daedalus Enterprises Inc.",
number = "6",

}

TY - JOUR

T1 - Integration of palliative care in chronic critical illness management

AU - Nelson, Judith E.

AU - Hope, Aluko A.

PY - 2012/6

Y1 - 2012/6

N2 - Palliative care is an essential component of comprehensive care for all patients with chronic critical illness, including those receiving restorative or life-sustaining therapies. Core elements include alleviation of symptom distress, communication about care goals, alignment of treatment with the patient's values and preferences, transitional planning, and family support. Here we address strategies for assessment and management of symptoms, including pain, dyspnea, and depression, and for assisting patients to communicate while endotracheally intubated. We also discuss approaches to optimize communication among clinicians, patients, and families about care goals. Challenges for supporting families and planning for transitions between care settings are identified, while the value of interdisciplinary input is emphasized. We review "consultative" and "integrative" models for integrating palliative care and restorative critical care. Finally, we highlight key ethical issues that arise in the care of chronically critically ill patients and their families.

AB - Palliative care is an essential component of comprehensive care for all patients with chronic critical illness, including those receiving restorative or life-sustaining therapies. Core elements include alleviation of symptom distress, communication about care goals, alignment of treatment with the patient's values and preferences, transitional planning, and family support. Here we address strategies for assessment and management of symptoms, including pain, dyspnea, and depression, and for assisting patients to communicate while endotracheally intubated. We also discuss approaches to optimize communication among clinicians, patients, and families about care goals. Challenges for supporting families and planning for transitions between care settings are identified, while the value of interdisciplinary input is emphasized. We review "consultative" and "integrative" models for integrating palliative care and restorative critical care. Finally, we highlight key ethical issues that arise in the care of chronically critically ill patients and their families.

KW - Communication

KW - Intensive care

KW - Mechanical ventilation

KW - Palliative care

UR - http://www.scopus.com/inward/record.url?scp=84863574775&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863574775&partnerID=8YFLogxK

U2 - 10.4187/respcare.01624

DO - 10.4187/respcare.01624

M3 - Article

C2 - 22663973

AN - SCOPUS:84863574775

VL - 57

SP - 1004

EP - 1012

JO - Respiratory Care

JF - Respiratory Care

SN - 0020-1324

IS - 6

ER -