Top Things to Know: Palliative and End of Life Care in Stroke
Published: December 16, 2024
Prepared by Sonija Shrestha DNP, ACNP, FNP, Associate Science and Medicine Advisor
- Palliative care should be integrated at every stage of stroke recovery, not just at end-of-life. This approach addresses the full spectrum of patient needs, including physical, emotional, and spiritual aspects, while supporting both patients and their families to improve quality of life and overall well-being.
- Palliative care for stroke is not limited to end-of-life stages but is meant to support quality of life and address evolving needs throughout all phases of recovery.
- Stroke patients have unique palliative needs distinct from other serious conditions, creating a specialized area called "neuropalliative care" that focuses on cognitive, physical, and psychosocial challenges.
- Advances in acute stroke treatments have reduced mortality rates, leading to a higher number of survivors who require long-term palliative care and support for chronic conditions resulting from stroke.
- Stroke survivors and their families face challenges such as loss of autonomy, cognitive and physical disabilities, and emotional distress, highlighting the need for comprehensive support.
- Patients and their families often experience anxiety, depression, and a need for spiritual guidance, which should be recognized and supported as core aspects of palliative care.
- Healthcare providers treating stroke patients should be trained in primary palliative care skills, including effective communication, symptom management, and understanding patient values and goals.
- Significant disparities exist in palliative care access and outcomes, especially among racial and ethnic minorities, requiring healthcare systems to address structural barriers and inequities.
- The statement suggests integrating palliative care from the initial hospitalization and throughout recovery to provide continuous, adaptable support as patient needs evolve.
- Clear, well-defined guidelines for hospice care are crucial, particularly for stroke patients experiencing severe symptoms in the end-of-life stages.
- The statement highlights an urgent need for more research into effective palliative care interventions for stroke patients, including culturally tailored models and multidimensional care assessment tools.
Citation
Creutzfeldt CJ, Bu J, Comer A, Enguidanos S, Lutz B, Robinson MT, Zahuranec DB, Holloway RG; on behalf of the American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; and Council on Clinical Cardiology. Palliative and end-of-life care in stroke: a scientific statement from the American HeartAssociation. Stroke. Published online December 16, 2024. doi: 10.1161/STR.0000000000000479