Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-17T16:31:36.390Z Has data issue: false hasContentIssue false

Chapter 18 - The Role of Palliative Care in the Intensive Care Unit

Published online by Cambridge University Press:  27 May 2021

By
Adeline L. Goss  and
Claire J. Creutzfeldt
Edited by
Matthew N. Jaffa  and
David Y. Hwang
Matthew N. Jaffa
Affiliation:
Hartford Hospital, Connecticut
David Y. Hwang
Affiliation:
Yale University, Connecticut
Get access

Summary

Originating mostly in the world of oncology, palliative care has matured into a wide-ranging field aimed at improving the quality of life of all patients and their families facing the problems associated with life-threatening illnesses. Palliative care aims at preventing and relieving physical, social, psychological, and spiritual suffering. Components of palliative care vary based on the setting, but generally include (1) relationship and rapport building with patients and family members; (2) addressing and managing physical, social, psychological, and spiritual symptoms; (3) eliciting patient and family values; (4) interpreting and communicating information about the patient’s illness, prognosis, and treatment options and ensuring understanding; (5) helping patients and families to cope with life-altering circumstances and preventing or managing grief; (6) identifying and resolving conflicts, either between family members, between different medical team members, or between family and medical teams; (7) assisting with goal setting and advance care planning; and (8) hospice referral and discharge planning.1,2 Palliative care can be provided to patients and their families in any setting and at any time during the course of an illness, and may be offered alongside curative treatment.

Type
Chapter
Information
Shared Decision Making in Adult Critical Care , pp. 157 - 166
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Tran, L.N., Back, A.L., Creutzfeldt, C.J.. Palliative care consultations in the neuro-ICU: a qualitative study. Neurocritical Care, 2016; 25(2): 266–72.Google Scholar
Yoong, J., Park, E.R., Greer, J.A., et al. Early palliative care in advanced lung cancer: a qualitative study. JAMA Internal Medicine, 2013; 173(4): 283–90.CrossRefGoogle ScholarPubMed
Angus, D.C., Barnato, A.E., Linde-Zwirble, W.T., et al. Use of intensive care at the end of life in the United States: an epidemiologic study. Critical Care Medicine, 2004; 32(3): 638–43.Google Scholar
Nelson, J.E., Meier, D.E., Litke, A., et al. The symptom burden of chronic critical illness. Critical Care Medicine, 2004; 32(7): 1527–34.CrossRefGoogle ScholarPubMed
Puntillo, K.A., Arai, S., Cohen, N.H., , et al. Symptoms experienced by intensive care unit patients at high risk of dying. Critical Care Medicine, 2010; 38(11): 2155–60.CrossRefGoogle ScholarPubMed
Cox, C.E., Carson, S.S., Lindquist, J.H., et al. Differences in one-year health outcomes and resource utilization by definition of prolonged mechanical ventilation: a prospective cohort study. Critical Care, 2007; 11(1): R9.CrossRefGoogle ScholarPubMed
Cox, C.E., Docherty, S.L., Brandon, D.H., et al. Surviving critical illness: acute respiratory distress syndrome as experienced by patients and their caregivers. Critical Care Medicine, 2009; 37(10): 2702–8.CrossRefGoogle ScholarPubMed
Wunsch, H., Guerra, C., Barnato, A.E., et al. Three-year outcomes for medicare beneficiaries who survive intensive care. JAMA, 2010; 303(9): 849–56.CrossRefGoogle ScholarPubMed
Creutzfeldt, C.J., Holloway, R.G., Curtis, J.R.. Palliative care: a core competency for stroke neurologists. Stroke, 2015; 46(9): 2714–9.CrossRefGoogle ScholarPubMed
Ferrell, B.R., Twaddle, M.L., Melnick, A., et al. National consensus project clinical practice guidelines for quality palliative care guidelines, 4th edition. Journal of Palliative Medicine, 2018; 21(12): 1684–9.CrossRefGoogle ScholarPubMed
America’s care of serious illness: a state-by-state report card on access to palliative care in our nation’s hospitals. New York: Center to Advance Palliative Care and the National Palliative Care Research Center; 2019.Google Scholar
Aslakson, R., Cheng, J., Vollenweider, D., Galusca, D., Smith, T.J., Pronovost, P.J.. Evidence-based palliative care in the intensive care unit: a systematic review of interventions. Journal of Palliative Medicine, 2014; 17(2): 219–35.CrossRefGoogle ScholarPubMed
Nelson, J.E., Bassett, R., Boss, R.D., et al. Models for structuring a clinical initiative to enhance palliative care in the intensive care unit: a report from the IPAL-ICU Project (Improving Palliative Care in the ICU). Critical Care Medicine, 2010; 38(9): 1765–72.CrossRefGoogle ScholarPubMed
Norton, S.A., Hogan, L.A., Holloway, R.G., et al. Proactive palliative care in the medical intensive care unit: effects on length of stay for selected high-risk patients. Critical Care Medicine, 2007; 35(6): 1530–5.CrossRefGoogle ScholarPubMed
Zalenski, R.J., Jones, S.S., Courage, C., et al. Impact of palliative care screening and consultation in the ICU: a multihospital quality improvement project. Journal of Pain and Symptom Management, 2017; 53(1): 5–12.e3.CrossRefGoogle ScholarPubMed
Campbell, M.L., Guzman, J.A.. A proactive approach to improve end-of-life care in a medical intensive care unit for patients with terminal dementia. Critical Care Medicine, 2004; 32(9): 1839.CrossRefGoogle Scholar
Mosenthal, A.C., Murphy, P.A., Barker, L.K., et al. Livingston. Changing the culture around end-of-life care in the trauma intensive care unit. Journal of Trauma, 2008; 64(6): 1587–93.Google Scholar
Lamba, S., Murphy, P., McVicker, S., et al. Changing end-of-life care practice for liver transplant service patients: structured palliative care intervention in the surgical intensive care unit. Journal of Pain and Symptom Management, 2012; 44(4): 508–19.CrossRefGoogle ScholarPubMed
Morrison, R.S., Penrod, J.D., Cassel, J.B., et al. Cost savings associated with US hospital palliative care consultation programs. Archives of Internal Medicine, 2008; 168(16): 1783–90.CrossRefGoogle ScholarPubMed
Kaufer, M., Murphy, P., Barker, K., et al. Family satisfaction following the death of a loved one in an inner city MICU. American Journal of Hospice and Palliative Medicine, 2008; 25(4): 318–25.CrossRefGoogle Scholar
Cox, C.E., Lewis, C.L., Hanson, L.C., et al. Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation. Critical Care Medicine, 2012; 40(8): 2327–34.CrossRefGoogle ScholarPubMed
Azoulay, E., Pochard, F., Chevret, S., et al. Impact of a family information leaflet on effectiveness of information provided to family members of intensive care unit patients: a multicenter, prospective, randomized, controlled trial. Am J Respir Critical Care Medicine, 2002; 165(4): 438–42.CrossRefGoogle ScholarPubMed
Burns, J.P., Mello, M.M., Studdert, D.M., et al. Results of a clinical trial on care improvement for the critically ill. Critical Care Medicine, 2003; 31(8): 2107–17.Google Scholar
White, D.B., Cua, S.M., Walk, R., et al. Nurse-led intervention to improve surrogate decision making for patients with advanced critical illness. American Journal of Critical Care, 2012; 21(6): 396–409.Google Scholar
White, D.B., Angus, D.C., A-M. et al. A Randomized trial of a family-support intervention in intensive care units. New England Journal of Medicine, 2018; 378(25): 2365–75.CrossRefGoogle ScholarPubMed
Curtis, J.R., Treece, P.D., Nielsen, E.L., et al. Randomized trial of communication facilitators to reduce family distress and intensity of end-of-life care. American Journal of Respiratory and Critical Care Medicine, 2015; 193(2): 154–62.Google Scholar
Lautrette, A., Michael, D., Bruno, M., et al. A communication strategy and brochure for relatives of patients dying in the ICU. New England Journal of Medicine, 2007; 356: 469–78.CrossRefGoogle ScholarPubMed
Lilly, C.M., De Meo, D.L., Sonna, L.A., et al. An intensive communication intervention for the critically ill. American Journal of Medicine 2000; 109(6): 469–75.CrossRefGoogle ScholarPubMed
Lilly, C., Sonna, L., Haley, K., et al. Intensive communication: four-year follow-up from a clinical practice study. Critical Care Medicine, 2003; 31(5 Suppl): S394–9.CrossRefGoogle ScholarPubMed
Quill, T.E., Abernethy, A.P.. Generalist plus specialist palliative care – creating a more sustainable model. New England Journal of Medicine, 2013; 368: 1173–5.CrossRefGoogle ScholarPubMed
Sihra, L., Harris, M., O’Reardon, C.. Using the improving palliative care in the intensive care unit (IPAL-ICU) project to promote palliative care consultation. Journal of Pain and Symptom Management, 2011; 42(5): 672–5.Google Scholar
Bradley, C.T., Brasel, K.J.. Developing guidelines that identify patients who would benefit from palliative care services in the surgical intensive care unit. Critical Care Medicine, 2009; 37(3): 946.CrossRefGoogle ScholarPubMed
Williams, M.T., Zimmerman, E., Barry, M., et al. A retrospective review of patients with acute stroke with and without palliative care consultations. American Journal of Hospice and Palliative Care, 2019; 36(1): 60–4.Google Scholar
Singh, T., Peters, S.R., Tirschwell, D.L., et al. Palliative care for hospitalized patients with stroke. Stroke, 2017; 48(9): 2534–40.CrossRefGoogle ScholarPubMed
Creutzfeldt, C., Engelberg, R., Healey, L., et al. Palliative care needs in the neuro-ICU. Critical Care Medicine, 2015; 43(8): 1677–84.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×