End-of-life and hospice care for neurologic illness

Daly, Farrah N.; Ramanathan, Usha

doi:10.1016/b978-0-323-85029-2.00006-3

Cited by 4 publications

(4 citation statements)

References 104 publications

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“…Secretions are managed through both pharmacologic and nonpharmacologic measures, with no evidence that any intervention is superior to placebo. 34,36 27 burden and subsequent noise from secretions. Strategic patient positioning, including elevation of the head of the bed and tilting patients to the side, helps to avert pooling of secretions and can reduce risk of aspiration.…”

Section: Secretionsmentioning

confidence: 99%

End-of-Life and Hospice Care in Neurologic Diseases

Chou,

Everett,

McFarlin

et al. 2024

Semin Neurol

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The care of a patient with neurologic disease at end-of-life requires expertise in addressing advance care planning, hospice, symptom management, and caregiver support. Neurologists caring for patients with advanced neurologic disease often identify changes in disease trajectory, functional status, or goals of care that prompt discussions of advance care planning and hospice. Patients nearing end-of-life may develop symptoms such as dyspnea, secretions, delirium, pain, and seizures. Neurologists may be the primary clinicians managing these symptoms, particularly in the hospitalized patient, though they may also lend their expertise to non-neurologists about expected disease trajectories and symptoms in advanced neurologic disease. This article aims to help neurologists guide patients and caregivers through the end-of-life process by focusing on general knowledge that can be applied across diseases as well as specific considerations in severe stroke and traumatic brain injury, amyotrophic lateral sclerosis, Parkinson's disease, and dementia.

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Section: Secretionsmentioning

confidence: 99%

End-of-Life and Hospice Care in Neurologic Diseases

Chou,

Everett,

McFarlin

et al. 2024

Semin Neurol

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“…For instance, due to the challenges of prognostication in end-stage neurological illness, there are limited criteria for determining hospice eligibility for these patients, particularly in neurodegenerative disease. 28 Neuropalliative care specialists may be able to provide more informed recommendations that facilitate hospice for these patients. In addition, end-of-life symptom management of patients with neurologic disease may significantly differ from the standard approach in patients with nonneurological illness.…”

Section: Hospicementioning

confidence: 99%

“…As a result, there have been calls to integrate neurological expertise into discussions about standards of care for dying patients. 28 There are no specific requirements or pathways for hospice physicians beyond usual medical training, and thus neurologists with enhanced primary palliative care training, as well as neuropalliative specialists, have the opportunity to pursue a career in hospice. 30…”

Section: Clinical Careers In Neuropalliative Carementioning

confidence: 99%

Pathways to Neuropalliative Care Practice

Harrigan,

Kirsch,

Adjepong

et al. 2024

Semin Neurol

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As neuropalliative care is better recognized and more widely utilized, there is as great a need for clinicians trained in the field as there is for disease-specific symptom management, advance care planning, and end-of-life care. In this manuscript, we describe potential career trajectories in neuropalliative care. For clinicians, this includes educational and training opportunities within primary neuropalliative care (integrating palliative care principles into usual neurology practice), specialty neuropalliative care (completing a hospice and palliative medicine fellowship), and hospice. We also describe considerations for establishing new clinical neuropalliative practices and highlight neuropalliative education and research as key areas for advancing the field.

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“…The lack of end-of-life care results in individuals dying isolated in hospitals and other care facilities. Symptomatic management must be aided by an interdisciplinary team with an integrated approach to enhance the quality of life for people who are dying [ 2 ]. Currently, there are about 20 million people worldwide requiring end-of-life care, which makes it a global public health concern [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Anorexia Nervosa: Evaluating Disparities in Places of Death in the United States Over 22 Years Using the CDC WONDER Database

Patel,

Tyagi,

Biswas

et al. 2023

Cureus

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Introduction: Anorexia nervosa is a severe and occasionally fatal eating disorder characterized by extreme weight loss and a distorted body image in which the affected individuals typically exhibit a strong fear of gaining weight, leading to rigid dietary restrictions and excessive activity. This condition can cause severe health problems, such as hunger, cardiovascular issues, and organ destruction. Anorexia nervosa is a key subject for research in the context of end-of-life care disparities due to its psychological and physical challenges. Aims: This study examines differences in the places of death for people with anorexia nervosa during a 22-year period in the USA, taking into account four important factors: age group, gender, race, and U.S. census region. Methodology: Data were collected from the CDC WONDER website on August 31, 2023, and spans years 1999 to 2020, using the particular ICD-11 code F50.0 for anorexia nervosa. The study aims to uncover the important determinants impacting the location of death within this specific population using sophisticated statistical methods, including univariate logistic regression. Results: The analysis of aggregate data yielded notable findings. The patient's principal site of death was at home or in hospice care. Other sites were less prevalent, with medical facilities or nursing homes ranking second. The place of death was highly influenced by age groups with diverse patterns. Gender had no significant impact; however, geographical inequalities were noticeable. Individuals in the Northeast, Midwest, and South were less likely than those in the West to die at home or in hospice care. The location of death was unaffected by race. Conclusions: In conclusion, this study found that death in home and hospice was more common than in medical or hospital nursing facilities in all four analyzed groups. These findings highlight the critical need for significant advancements in end-of-life care, particularly in home and hospice settings.

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End-of-life and hospice care for neurologic illness

Cited by 4 publications

References 104 publications

End-of-Life and Hospice Care in Neurologic Diseases

End-of-Life and Hospice Care in Neurologic Diseases

Pathways to Neuropalliative Care Practice

Anorexia Nervosa: Evaluating Disparities in Places of Death in the United States Over 22 Years Using the CDC WONDER Database

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