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Many Patient Miss Out On Palliative Care After A Severe Stroke. Here's Why - medtigo

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Many Patient Miss Out On Palliative Care After A Severe Stroke. Here’s Why

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Being admitted to the hospital for a significant disease such as a stroke might be one of the most traumatic experiences a person can have.

Why do few people use a medical specialty to reduce pain and suffering during hospitalization?

Palliative care practitioners prioritize pain management and symptom reduction throughout medical treatment to improve patients’ quality of life. They also assist sick individuals and their loved ones in coping with stress and grief and guiding them through difficult decisions.

According to a recent study published in the Journal of Pain and Symptom Management and as reported by US News, just 1 in 5 persons hospitalized with a significant stroke received a palliative care consultation in the previous three years.

“I don’t think every patient with a major stroke requires a palliative care consult,” said senior author Dr. Alexia Torke, a research scientist at the Regenstrief Institute in Indianapolis. “But I feel it should be more than 20%,” she said.

“Such a life-changing event necessitates a great deal of support for the patient and family, and palliative care is one part of assistance for coping with a life-threatening illness and making decisions,” she continued.

Palliative care is a field that is still developing. It is frequently confused with hospice care, which is “particularly focused on the very end of life and patients who are dying,” according to Dr. R. Sean Morrison, chairman of Mount Sinai’s Brookdale Department of Geriatrics and Palliative Medicine. He was not a participant in the research.

On the other hand, Palliative care is intended to relieve the suffering of all patients, regardless of their prognosis, according to Morrison and Torke.

“Palliative care is team-based care focused on enhancing the quality of life for individuals of all ages living with serious illnesses. It may and should be offered simultaneously as all other appropriate therapies, including those to prolong life,” Morrison explained.

“People experience less pain and other symptoms when palliative care is provided simultaneously. For example, their families feel more cared for and supported, and they live longer in cancer,” he added.

Between 2016 and 2019, Torke and her colleagues examined nearly 1,300 severe stroke cases at four Indiana hospitals to evaluate how often palliative care was utilized to benefit patients. They looked through patient records to discover if a palliative care team had met with the patient or their family.

According to the researchers, palliative care was provided in various situations, ranging from 12 percent to 43 percent of severe stroke victims depending on the hospital.

According to the findings, just 43% of patients who died in the hospital received a palliative care consultation.

Palliative care was provided to “less than half of the patients who died in hospitals when the patient and family were likely faced with tough decisions and could have benefited from a lot of assistance,” according to Torke.

Only 24% of patients who died within three days of being admitted to the hospital received palliative treatment, compared to 51% of patients who died on or after day four.

“On a positive side, we did find that individuals with a higher stroke severity tended to have more consults, which is beneficial,” Torke said.

According to Morrison, because palliative care is a relatively new specialty of medicine, many doctors are unfamiliar with it and when it should be used.

“The vast majority of practicing physicians have never received palliative care and have not been trained in it,” Morrison explained, “so they don’t know when to call them when they’re required.”

This lack of understanding extends to hospitalized patients as well.

“Patients and their families are unsure what palliative care is and how it may benefit them,” Morrison added. “They don’t know how to request it.”

The distinction between palliative care and hospice may also deter people from obtaining this treatment, according to Torke.

“We’re here to support patients and families in making decisions,” Torke said. “Whether they want to pursue life-sustaining treatments or focus their care on comfort and eventually transfer to hospice, we’re here to support them. There’s a perception that having a palliative care consultation means we’re given up or aren’t as supportive of patients’ preferences and choices.”

Doctors need more training to recognize when a patient would benefit from a palliative care consultation, according to Torke.

“It might be that the physician detects a lot of distress in either the patient or a family member, and they’re having trouble dealing,” she explained. “A palliative care consult may be required at certain times.”

Morrison believes hospitals can help by including palliative care into their regular patient care routines, making it just another available service.

“We were one of the first pioneers in palliative care in my hospital,” Morrison added. “All of our intensive care units, including our stroke unit and oncology program, now have teams. We’ve only recently joined the healthcare scene.”

Morrison also believes that palliative care professionals should do a better job of enlightening the public about the benefits of their field.

“I can assure you that if you see my palliative care colleague, your symptoms will be better treated, your family will be better cared for, and your life will be extended. It simply has to be included in routine medical care, “he stated

Bottom line: “Patients and families must be willing to ask for it because unless they do, doctors will not be able to deliver it adequately because they will not think about it,” Morrison said. “It’s their right, and they’ll get better health care.”

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