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Semin Neurol 2021; 41(05): 619-630
DOI: 10.1055/s-0041-1731071
Review Article

Neuropalliative Care in the Inpatient Setting

Adeline L. Goss
1   Department of Neurology, University of California San Francisco, San Francisco, California
,
Claire J. Creutzfeldt
2   Department of Neurology, University of Washington, Seattle, Washington
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Abstract

The palliative care needs of inpatients with neurologic illness are varied, depending on diagnosis, acuity of illness, available treatment options, prognosis, and goals of care. Inpatient neurologists ought to be proficient at providing primary palliative care and effective at determining when palliative care consultants are needed. In the acute setting, palliative care should be integrated with lifesaving treatments using a framework of determining goals of care, thoughtfully prognosticating, and engaging in shared decision-making. This framework remains important when aggressive treatments are not desired or not available, or when patients are admitted to the hospital for conditions related to advanced stages of chronic neurologic disease. Because prognostic uncertainty characterizes much of neurology, inpatient neurologists must develop communication strategies that account for uncertainty while supporting shared decision-making and allowing patients and families to preserve hope. In this article, we illustrate the approach to palliative care in inpatient neurology.

Keywords

palliative care - critical care - stroke - traumatic brain injury


Publication History

Article published online:
07 October 2021

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