Neuropalliative Care: A Practical Guide for the Neurologist

Abstract

Neuropalliative care is a new and growing field within neurology that focuses on improving the quality of life of patients with serious neurologic illnesses. While specialty-level palliative care training is available to interested neurologists, all neurologists can strive to provide primary palliative care for their patients. In this review, we will describe the scope of neuropalliative care, define patient populations who may benefit from palliative care, and explore the communication and symptom management skills essential to palliative care delivery.

Palliative specialists for patients with ALS: Making best use of a limited resource

“…A neuropalliative skillset is applicable to a wide array of neurologic patient care settings, and many models of delivering this care exist to guide practitioners of different skill levels and training background in identifying the appropriate patients, indications, and times to have these conversations. 5,[10][11][12] Few neurologists, though, will pursue additional formal training in palliative medicine, and a scarcity of general palliative specialists limits widespread availability of highly skilled specialty palliative services at smaller centers. [13][14][15][16] Some neurologists will fully practice primary palliative skills, managing symptoms and guiding conversations about goals of care and complex decision-making about issues such as feeding tubes, tracheostomy and ventilation, hospice, and legal physician-hastened death (PHD).…”

Neuropalliative care: new perspectives of intensive care

“…Furthermore, given their particularities, these challenges require their own approach, which was recently termed "neuropalliative care". ( 2 , 10 )…”

“…The literature indicates that a wide variety of neurological patients can benefit from PC. ( 2 ) Brizzi et al propose a classification of these patients into four categories according to the progression of neurological disease to assist in the identification of specific needs: (1) patients with rapid or (2) prolonged decline, (3) episodic decline and (4) acute decline and uncertain recovery. ( 2 ) In cases of acute decline, for example, the demand for symptom management may be high, while for those with prolonged decline, eventual caregiver burnout may be a more evident need.…”

“…( 2 ) In cases of acute decline, for example, the demand for symptom management may be high, while for those with prolonged decline, eventual caregiver burnout may be a more evident need. ( 2 )…”

Clinical Decision‐Making for Patients with Disorders of Consciousness

“…Unlike in the Netherlands series, neurologists should routinely refer UWS/VS patients to specialized neurorehabilitation units upon hospital discharge, thus allowing many patients later to successfully accommodate themselves to their disability . We urged physicians caring for these patients to abide by the AAN guidelines and follow the principles and practice of neuropalliative care …”