Stroke, Epilepsy, and Neurological Diseases
Current opinion in neurology is to integrate palliative aid before the final stage of neurological disease. This concept has been applied to stroke, epilepsy, and general aspects of other neurological diseases. Stroke results in high levels of mortality a
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Stroke, Epilepsy, and Neurological Diseases María Gudín
Palliative care addresses the physical and psychological aspects of end of life. The World Health Organization defines palliative care as: “an approach that improves quality of life of patients and their families facing the problem associated with lifethreatening illness, through the prevention and relief of sufferings by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual. Palliative care: provides relief either for pain and other distressing symptoms; affirms life and regards dying as a normal process; intends neither to hasten nor to postpone death; integrates the psychosocial and spiritual aspects of patient care; offers a support system to help patient live as active as possible until death; offers a system to help the family cope during the patient illness and in their own bereavement, counseling, if indicated; will enhance quality of life, and may also positively influence the course of the illness; is applicable early in the course of the illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy and radiation therapy and includes those investigations needed to better understand and manage distressing clinical complications” [1]. Even though palliative care was developed around terminal cancer care, nowadays palliative care principles are applicable to neurology illnesses. Given the chronic course of the neurological life-threatening diseases, some authors support incorporing palliative care in neurology in early stages of the disease. Current opinion in neurology is to integrate palliative aid before the final stage of neurological disease (i.e., approximately the final 2 week of life) [2].
M. Gudín, Ph.D. (*) Neurology Department, Ciudad Real General University Hospital, Ciudad Real, Castilla–La Mancha, Spain e-mail: [email protected]; [email protected] N. Vadivelu et al. (eds.), Essentials of Palliative Care, DOI 10.1007/978-1-4614-5164-8_16, © Springer Science+Business Media New York 2013
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Stroke Neurologist care for many patients who die because cerebrovascular disease is the third leading cause of death in the USA [3]. The incidence of stroke continues to rise [4] despite prevention strategies such as blood pressure control, treatment on atrial fibrillation, smoking dishabituation, weight control, instituting a modest exercise regimen [5], and aggressive treatment with thrombolytic agents [6, 7]. Stroke results in high levels of mortality and morbidity, yet very little is known about the nature and extent of palliative care services that are available to this patient group, and the ways in which such services could be delivered. A critical review of the international literature found only seven papers that attempted to identify the palliative care needs of patients diagnosed with stroke [8]. The results of the review showed that the preferences of stroke patients and their families in relati
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