Palliative care is patient- and family-centered care that improves life by anticipating, preventing and treating suffering. Although there is a strong emphasis within palliative care on end of life care, palliative care is appropriate for all patients with serious illness, regardless of illness stage. 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 in AHA/ASA's Stroke journal.
According to Robert Holloway, M.D., M.P.H., lead author of the statement and professor and chairman of the neurology department at the University of Rochester in Rochester, New York, palliative care should be a collaboration between patients, families, a stroke team and various providers, including neurologists, neurosurgeons, primary care providers, nurses and therapists.
As a stroke survivor or family member, you should expect your healthcare provider to:
- Talk about your preferences, needs and values as a guide to medical decisions.
- Discuss what aspects of recovery are most important to you.
- Have effective, sensitive discussions about your prognosis, how to deal with physical or mental losses from a stroke, and if necessary, of dying, among other serious topics.
- Guide you through choices about life-sustaining treatment options. Providers should address pros and cons of CPR, ventilators, feeding tubes, surgery, do-not-resuscitate orders (DNR), do-not-intubate (DNI) orders and natural feeding.
- Know the best treatment options for common post-stroke symptoms, including pain, other physical symptoms and psychological problems like 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.