Integration of palliative care in chronic critical illness management

Judith E. Nelson, Aluko A. Hope

Research output: Contribution to journalReview article

26 Scopus citations

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

Keywords

  • Communication
  • Intensive care
  • Mechanical ventilation
  • Palliative care

ASJC Scopus subject areas

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

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