Palliative care should be integrated into stroke care, study

Outcomes, experiences and palliative care in major stroke.

Caring nurse or doctor holding elderly lady's hand with care.
Caring nurse or doctor holding elderly lady's hand with care. Image: Shutterstock

Stroke is the 2nd leading cause of death. Survival is especially poor for people who have had a severe total anterior circulation stroke with loss of motor control, language and other conditions.

A new study that published in the CMAJ (Canadian Medical Association Journal), health care providers should focus on social and emotional issues in addition to physical rehabilitation that patients are facing while caring for stroke patients.

The study conducted on 29 patients in Scotland looked at the experiences, concerns, and priorities of patients, families and healthcare professionals in the 12 months after stroke. During the 1st 6 months, almost 125 people died. On the other hand, 132 patients died in a 1-year fatality. About two-thirds (67%) of deaths occurred within the first month after stroke.

Researchers found that patients and their families reported grief over the loss of their previous life, anxiety among caregivers over whether they were “doing the right thing,” uncertainty about the future and confusion about prognosis. As well, the term “palliative care” was interpreted negatively by many health care providers, families, and informal caregivers, as it is associated with care for people, for example, patients with advanced cancer, who are dying.

Dr. Scott Murray, Primary Palliative Care Research Group, University of Edinburgh said, “Rather than focusing only on physical rehabilitation, a realistic approach to managing care should consider the emotional needs of patients and their caregivers. Balancing the need for hope of recovery with the potential of severe disability or death is important in this approach.”

“Many patients and informal caregivers would have welcomed more support in making decisions and in planning for the future from day one. The focus was on active rehabilitation, recovery, motivation, and hope, with much less discussion and preparation for limited recovery.”

The creators propose that the standards of palliative care instead of the term itself ought to be connected to stroke patients, which implies supporting individuals to live well with falling apart wellbeing and making them agreeable until their possible demise.

Dr. Jessica Simon, Department of Oncology, University of Calgary said, “the challenging questions for physicians and other healthcare providers should not be, ‘What shall we call it?’ or ‘Who should receive palliative care?’; the questions for each patient who is facing the challenges associated with the life-threatening illness should be, ‘Am I providing the palliative care support my patient needs?’ and ‘Is there access to sufficient specialist palliative care resources in my community if needed?’.”