http://stroke.ahajournals.org/content/early/2014/03/27/STR.0000000000000015.abstract
- Robert G. Holloway, MD, MPH, Chair,
- Robert M. Arnold, MD,
- Claire J. Creutzfeldt, MD,
- Eldrin F. Lewis, MD, MPH,
- Barbara J. Lutz, PhD, RN, CRRN, FAHA, FAAN,
- Robert M. McCann, MD,
- Alejandro A. Rabinstein, MD, FAHA,
- Gustavo Saposnik, MD, MSc, FAHA, FRCPC,
- Kevin N. Sheth, MD, FAHA,
- Darin B. Zahuranec, MD, MS, FAHA,
- Gregory J. Zipfel, MD,
- Richard D. Zorowitz, MD, FAHA,
- on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, and Council on Clinical Cardiology
Abstract
Background and Purpose—The
purpose of this statement is to delineate basic expectations regarding
primary palliative care competencies and skills
to be considered, learned, and practiced by
providers and healthcare services across hospitals and community
settings when
caring for patients and families with stroke.
Methods—Members of
the writing group were appointed by the American Heart Association
Stroke Council’s Scientific Statement Oversight
Committee and the American Heart
Association’s Manuscript Oversight Committee. Members were chosen to
reflect the diversity
and expertise of professional roles in
delivering optimal palliative care. Writing group members were assigned
topics relevant
to their areas of expertise, reviewed the
appropriate literature, and drafted manuscript content and
recommendations in accordance
with the American Heart Association’s
framework for defining classes and level of evidence and
recommendations.
Results—The
palliative care needs of patients with serious or life-threatening
stroke and their families are enormous: complex decision
making, aligning treatment with goals, and
symptom control. Primary palliative care should be available to all
patients with
serious or life-threatening stroke and their
families throughout the entire course of illness. To optimally deliver
primary
palliative care, stroke systems of care and
provider teams should (1) promote and practice patient- and
family-centered care;
(2) effectively estimate prognosis; (3)
develop appropriate goals of care; (4) be familiar with the evidence for
common stroke
decisions with end-of-life implications; (5)
assess and effectively manage emerging stroke symptoms; (6) possess
experience
with palliative treatments at the end of
life; (7) assist with care coordination, including referral to a
palliative care
specialist or hospice if necessary; (8)
provide the patient and family the opportunity for personal growth and
make bereavement
resources available if death is anticipated;
and (9) actively participate in continuous quality improvement and
research.
Conclusions—Addressing
the palliative care needs of patients and families throughout the
course of illness can complement existing practices
and improve the quality of life of stroke
patients, their families, and their care providers. There is an urgent
need for
further research in this area.
Full text here, only 31 pages. For all the effort expended in this piece of shit they could have solved one of the neuronal cascade of death problems.
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