TY - JOUR
T1 - Palliative Care and End-of-Life Considerations for the Frail Patient
AU - Crooms, Rita C.
AU - Gelfman, Laura P.
N1 - Publisher Copyright:
© 2020 International Anesthesia Research Society.
PY - 2020
Y1 - 2020
N2 - Patients with frailty experience substantial physical and emotional distress related to their condition and face increased morbidity and mortality compared with their nonfrail peers. Palliative care is an interdisciplinary medical specialty focused on improving quality of life for patients with serious illness, including those with frailty, throughout their disease course. Anesthesiology providers will frequently encounter frail patients in the perioperative period and in the intensive care unit (ICU) and can contribute to improving the quality of life for these patients through the provision of palliative care. We highlight the opportunities to incorporate primary palliative care, including basic symptom management and straightforward goals-of-care discussions, provided by the primary clinicians, and when necessary, timely consultation by a specialty palliative care team to assist with complex symptom management and goals-of-care discussions in the face of team and/or family conflict. In this review, we apply the principles of palliative care to patients with frailty and synthesize the evidence regarding methods to integrate palliative care into the perioperative and ICU settings.
AB - Patients with frailty experience substantial physical and emotional distress related to their condition and face increased morbidity and mortality compared with their nonfrail peers. Palliative care is an interdisciplinary medical specialty focused on improving quality of life for patients with serious illness, including those with frailty, throughout their disease course. Anesthesiology providers will frequently encounter frail patients in the perioperative period and in the intensive care unit (ICU) and can contribute to improving the quality of life for these patients through the provision of palliative care. We highlight the opportunities to incorporate primary palliative care, including basic symptom management and straightforward goals-of-care discussions, provided by the primary clinicians, and when necessary, timely consultation by a specialty palliative care team to assist with complex symptom management and goals-of-care discussions in the face of team and/or family conflict. In this review, we apply the principles of palliative care to patients with frailty and synthesize the evidence regarding methods to integrate palliative care into the perioperative and ICU settings.
UR - http://www.scopus.com/inward/record.url?scp=85084721017&partnerID=8YFLogxK
U2 - 10.1213/ANE.0000000000004763
DO - 10.1213/ANE.0000000000004763
M3 - Article
C2 - 32384340
AN - SCOPUS:85084721017
SN - 0003-2999
VL - 130
SP - 1504
EP - 1515
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
IS - 6
ER -