Delirium

2021 ◽  
pp. 764-772
Author(s):  
Meera Agar ◽  
Yesne Alici ◽  
Augusto Caraceni ◽  
William Breitbart
Keyword(s):  
Palliative Care ◽  
Poor Prognosis ◽  
Symptom Control ◽  
Care Patient ◽  
Treatment Goals ◽  
Palliative Care Patient ◽  
Significant Morbidity ◽  
Pharmacological Interventions ◽  
Advanced Illness ◽  
Illness Trajectory

Delirium is the most common and serious neuropsychiatric disorder experienced by people with advanced illness. It leads to significant morbidity, and significant distress for the person themselves, family members and staff. Delirium often bodes of a poor prognosis and can significantly interfere with pain and symptom control. Unfortunately, delirium is often under-recognized or misdiagnosed in the palliative care patient, and even when recognized, it frequently goes untreated or is inappropriately treated. Clinicians who care for patients with advanced illness must be able to diagnose delirium accurately; undertake appropriate assessment of aetiologies and consider their treatment with due consideration of treatment goals and illness trajectory; and individualize the pharmacological and non-pharmacological interventions to support delirium recovery, maximize patient safety, and reduce distress from symptoms.

Delirium

2015 ◽  
Author(s):  
Meera Agar ◽  
Yesne Alici ◽  
William S. Breitbart
Keyword(s):  
Palliative Care ◽  
Symptom Control ◽  
Terminally Ill ◽  
Symptomatic Treatment ◽  
Significant Morbidity ◽  
Pharmacological Interventions ◽  
Advanced Illness ◽  
Delirious Patient ◽  
Risks And Benefits ◽  
Impending Death

Delirium is the most common and serious neuropsychiatric complication in palliative care settings. It is a source of significant morbidity in patients, and often distresses family members and staff. Delirium is often a harbinger of impending death and can significantly interfere with pain and symptom control. Unfortunately delirium is often under-recognized or misdiagnosed in the terminally ill, and even when recognized, it frequently goes untreated or is inappropriately treated. Clinicians who care for patients with advanced illness must be able to diagnose delirium accurately, undertake appropriate assessment of aetiologies, and understand the risks and benefits of the pharmacological and non-pharmacological interventions currently available for managing delirium. Symptomatic treatment with antipsychotics or sedative medications is often necessary for the delirious patient with advanced illness to minimize distress to patients, families, and staff.

scholarly journals Safety and Utility of Chloroquine/ Hydroxychloroquine in Palliative Care Patients

2020 ◽  
pp. 104990912095277
Author(s):  
Eric Prommer
Keyword(s):  
Palliative Care ◽  
Inflammatory Responses ◽  
Therapeutic Potential ◽  
Symptom Control ◽  
In Vivo Studies ◽  
Advanced Illness ◽  
Know How ◽  
Seriously Ill

The coronavirus disease 2019 (COVID-19) pandemic represents a significant healthcare challenge for the world. Many drugs have therapeutic potential. The aminoquinolones, hydroxychloroquine, and chloroquine are undergoing evaluation as a potential therapy against COVID -19. In vitro and in vivo studies suggest that these drugs affect viral adherence and modify inflammatory responses, which may provide some impact on the symptoms associated with COVID. As palliative care specialists encounter more COVID positive patients, palliative care specialists need to know how these drugs work, and importantly how they interact with palliative care drugs used for symptom control. At the same time, there is a need to reduce polypharmacy in any seriously ill patient population. The goals of this paper are to identify whether or not hydroxychloroquine/chloroquine improves symptoms in palliative care patients and whether or not these drugs are safe to use in the advanced illness population who have COVID.

scholarly journals Hypercalcemia of malignancy in the palliative care patient: A treatment strategy

1995 ◽  
Vol 10 (3) ◽  
pp. 224-232 ◽  
Author(s):  
Christopher S. Kovacs ◽  
Susan M. MacDonald ◽  
Constance L. Chik ◽  
Eduardo Bruera
Keyword(s):  
Palliative Care ◽  
Treatment Strategy ◽  
Care Patient ◽  
Palliative Care Patient ◽  
Hypercalcemia Of Malignancy

scholarly journals Pediatric Palliative Care Pharmacy Pearls—A Focus on Pain and Sedation

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 902
Author(s):  
Jennifer Placencia ◽  
Kevin Madden
Keyword(s):  
Palliative Care ◽  
Adult Patient ◽  
Pediatric Patient ◽  
Pediatric Patients ◽  
Care Patient ◽  
Pediatric Palliative Care ◽  
Palliative Care Patient ◽  
Dosing Regimen ◽  
Developmental Pharmacology ◽  
Optimal Dosing

Determining the optimal dosing regimen for pediatric patients is a challenge due to the lack of dosing guidelines and studies. In addition, many developmental pharmacology changes that occur throughout childhood that have profound impacts on the absorption, distribution, metabolism, and elimination of medications are commonly used in palliative care. Adding to that complexity, certain medications have different effects in the pediatric patient compared to the adult patient. Being aware of the pharmacokinetic changes, impact on neurodevelopment and unique medication factors that are present in pediatric patients helps clinicians treat the pediatric palliative care patient in the best and safest way possible.

Family Stress

2021 ◽  
pp. 431-441
Author(s):  
Denis Snow ◽  
Mary Ellen Lasala
Keyword(s):  
Palliative Care ◽  
Family Stress ◽  
Care Patient ◽  
Family Preservation ◽  
Palliative Care Patient ◽  
Legal Requirements ◽  
Serious Illness ◽  
Faith Based ◽  
Culturally Appropriate Care ◽  
Advance Planning

Serious illness creates a need for financial and legal support for individuals and their families. Nonmedical issues are often as pressing on them as their medical concerns. Clinicians must have a basic understanding of meeting those needs of advance planning, income and family maintenance, access to insurance, and family preservation within the context of culturally appropriate care. Knowledge of community and faith-based resources to meet the nonmedical needs of the palliative care patient is an essential aspect of care. Since these are often unknown to patients and their families, the clinician must know how to guide patients through the morass of cultural and legal requirements for this purpose.

Care of children with advanced illness

2021 ◽  
pp. 1035-1045
Author(s):  
Myra Bluebond-Langner ◽  
Richard W. Langner ◽  
Ignasi Clemente
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Advanced Illness ◽  
Illness Trajectory ◽  
Paediatric Palliative Care ◽  
Life Threatening ◽  
Decision Making Processes ◽  
Care And Treatment ◽  
Parent Child

Based on the holistic, family-centred approach of paediatric palliative care, this chapter examines specific aspects of the clinician, parent, and child roles in the care and treatment of children and young persons with life-limiting conditions and life-threatening illnesses. In particular, it identifies communication, information, decision-making, and participation preferences of children and young persons with advanced illness and their parents. Within the clinician–parent–child triad, the chapter sets forward suggestions for clinicians on how to manage differences between a child and his or her parents, and more generally, on how to approach the communication and decision-making processes throughout a child’s or young person’s illness trajectory.

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