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Statement outlines palliative care for stroke survivors

Friday March 28, 2014
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People recovering from a stroke should have a well-coordinated medical team to personalize care, optimize quality of life and minimize suffering, according to a scientific statement published by the American Heart Association.

The statement, published March 27 on the website of the journal Stroke, is the first in the U.S. to outline fundamental palliative care for stroke survivors, according to a news release.

“The majority of stroke patients need access to some form of palliative medicine,” Robert Holloway, MD, MPH, lead author of the statement and professor and chairman of the neurology department at the University of Rochester (N.Y.), said in the news release. “The stroke team and its members can manage many of the palliative care problems themselves. It encourages patient independence and informed choices.”

Palliative care should be a collaboration between patients, families, a stroke team and various providers, including neurologists, neurosurgeons, primary care providers, nurses and therapists, Holloway said.

According to the statement, stroke survivors and family members should expect healthcare providers to:

• Discuss their preferences, needs and values as a guide to medical decisions;

• Discuss what aspects of recovery are most important to them;

• Have effective, sensitive discussions about the prognosis, how to deal with physical or mental losses from a stroke and, if necessary, about dying, among other serious topics;

• Provide guidance regarding life-sustaining treatment options. Providers should address pros and cons of CPR, ventilators, feeding tubes, surgery, do-not-resuscitate orders, do-not-intubate orders and natural feeding;

• Know the best treatment options for common post-stroke symptoms, including pain, other physical symptoms and psychological problems such as depression and anxiety;

• Engage a palliative care specialist if complex issues arise;

• Help preserve dignity and maximize comfort throughout the course of a stroke, including during the dying process and when nearing death;

“Stroke is a devastating disease that has received little attention in the area of palliative care so far,” Holloway said.

Nearly 800,000 stroke and 130,000 stroke-related deaths occur in the U.S. each year. Up to 30% of all survivors are permanently disabled.

Scientific statement: http://bit.ly/1dwXs6t


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