Palliative and end-of-life care in stroke: A statement for healthcare professionals from the American heart association/american stroke association

Robert G. Holloway, Robert M. Arnold, Claire J. Creutzfeldt, Eldrin F. Lewis, Barbara J. Lutz, Robert M. McCann, Alejandro Rabinstein, Gustavo Saposnik, Kevin N. Sheth, Darin B. Zahuranec, Gregory J. Zipfel, Richard D. Zorowitz

Research output: Contribution to journalArticle

112 Citations (Scopus)

Abstract

Background and Purpose: The purpose of this statement is to delineate basic expectations regarding primary palliative care competencies and skills to be considered, learned, and practiced by providers and healthcare services across hospitals and community settings when caring for patients and families with stroke. METHODS-: Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee. Members were chosen to reflect the diversity and expertise of professional roles in delivering optimal palliative care. Writing group members were assigned topics relevant to their areas of expertise, reviewed the appropriate literature, and drafted manuscript content and recommendations in accordance with the American Heart Association's framework for defining classes and level of evidence and recommendations. RESULTS-: The palliative care needs of patients with serious or life-threatening stroke and their families are enormous: complex decision making, aligning treatment with goals, and symptom control. Primary palliative care should be available to all patients with serious or life-threatening stroke and their families throughout the entire course of illness. To optimally deliver primary palliative care, stroke systems of care and provider teams should (1) promote and practice patient-and family-centered care; (2) effectively estimate prognosis; (3) develop appropriate goals of care; (4) be familiar with the evidence for common stroke decisions with end-of-life implications; (5) assess and effectively manage emerging stroke symptoms; (6) possess experience with palliative treatments at the end of life; (7) assist with care coordination, including referral to a palliative care specialist or hospice if necessary; (8) provide the patient and family the opportunity for personal growth and make bereavement resources available if death is anticipated; and (9) actively participate in continuous quality improvement and research. CONCLUSIONS-: Addressing the palliative care needs of patients and families throughout the course of illness can complement existing practices and improve the quality of life of stroke patients, their families, and their care providers. There is an urgent need for further research in this area.

Original languageEnglish (US)
Pages (from-to)1887-1916
Number of pages30
JournalStroke
Volume45
Issue number6
DOIs
StatePublished - Jan 1 2014

Fingerprint

American Heart Association
Terminal Care
Palliative Care
Stroke
Delivery of Health Care
Primary Health Care
Manuscripts
Patient Care Planning
Professional Role
Bereavement
Patient-Centered Care
Hospices
Family Practice
Quality Improvement
Research
Health Personnel
Decision Making
Referral and Consultation
Quality of Life

Keywords

  • AHA Scientific Statements
  • end of life care
  • hospice care
  • palliative care
  • prognosis
  • stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Holloway, R. G., Arnold, R. M., Creutzfeldt, C. J., Lewis, E. F., Lutz, B. J., McCann, R. M., ... Zorowitz, R. D. (2014). Palliative and end-of-life care in stroke: A statement for healthcare professionals from the American heart association/american stroke association. Stroke, 45(6), 1887-1916. https://doi.org/10.1161/STR.0000000000000015

Palliative and end-of-life care in stroke : A statement for healthcare professionals from the American heart association/american stroke association. / Holloway, Robert G.; Arnold, Robert M.; Creutzfeldt, Claire J.; Lewis, Eldrin F.; Lutz, Barbara J.; McCann, Robert M.; Rabinstein, Alejandro; Saposnik, Gustavo; Sheth, Kevin N.; Zahuranec, Darin B.; Zipfel, Gregory J.; Zorowitz, Richard D.

In: Stroke, Vol. 45, No. 6, 01.01.2014, p. 1887-1916.

Research output: Contribution to journalArticle

Holloway, RG, Arnold, RM, Creutzfeldt, CJ, Lewis, EF, Lutz, BJ, McCann, RM, Rabinstein, A, Saposnik, G, Sheth, KN, Zahuranec, DB, Zipfel, GJ & Zorowitz, RD 2014, 'Palliative and end-of-life care in stroke: A statement for healthcare professionals from the American heart association/american stroke association', Stroke, vol. 45, no. 6, pp. 1887-1916. https://doi.org/10.1161/STR.0000000000000015
Holloway, Robert G. ; Arnold, Robert M. ; Creutzfeldt, Claire J. ; Lewis, Eldrin F. ; Lutz, Barbara J. ; McCann, Robert M. ; Rabinstein, Alejandro ; Saposnik, Gustavo ; Sheth, Kevin N. ; Zahuranec, Darin B. ; Zipfel, Gregory J. ; Zorowitz, Richard D. / Palliative and end-of-life care in stroke : A statement for healthcare professionals from the American heart association/american stroke association. In: Stroke. 2014 ; Vol. 45, No. 6. pp. 1887-1916.
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