Nursing’s Role in Addressing Palliative Care Needs of Stroke Patients
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Although patient survival after stroke has improved, stroke remains a leading cause of death and severe disability. It is the second leading cause of death globally1 and fifth in the United States.2 The risk of death in the first 5 years after stroke is ≈50%, with the greatest risk in the first year.3 With advances in acute stroke treatment, stroke survivors and their family members are faced with making potentially life-altering decisions in both acute and chronic phases of stroke. Patient and family engagement in decision-making is critical, especially when faced with treatment decisions that may include transitioning from active treatment to a palliative approach to care. Palliative care is an emerging focal area and an important part of stroke care, but healthcare professionals are still uncertain about the intersection of palliative care with acute stroke care and the timing of initiating transitions to palliative care.4 Given these uncertainties, the palliative care needs of patients and families may go unrecognized. The purpose of this article is to provide an overview of stroke palliative care and recommendations for nurses caring for stroke patients and their families.
Palliative care is defined by the World Health Organization as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems” (WHO Definition of Palliative Care,5 paragraph 1). Palliative care throughout the illness continuum involves addressing physical, intellectual, emotional, social, and spiritual needs and facilitating patient autonomy, access to information, and choice.5,6 Table 1 includes key elements of palliative care.5
Palliative care may be appropriate at any stage …