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Palliative Care and Stroke

  • Peter EastmanEmail author
  • Brian Le
Reference work entry

Abstract

There have been significant advances in the prevention and management of stroke over the last few decades. Despite these important developments, stroke, both in the acute and chronic phases, remains a major cause of morbidity and mortality. The value of integrating palliative care principles and practices into stroke care management is being increasingly recognized across a range of domains including symptom management, assistance with complex decision-making, discharge planning, and end-of-life care. This chapter will explore the logistics, benefits, complexities, and challenges associated with the evolving relationship between stroke and palliative care services.

References

  1. Addington-Hall J, Lay M, Altmann D, McCarthy M. Symptom control, communication with health professionals, and hospital care of stroke patients in the last year of life as reported by surviving family, friends, and officials. Stroke. 1995;26(12):2242–8.PubMedGoogle Scholar
  2. Alonso A, Ebert AD, Dörr D, Buchheidt D, Hennerici MG, Szabo K. End-of-life decisions in acute stroke patients: an observational cohort study. BMC Palliat Care. 2016;15(1):1.Google Scholar
  3. Andersen KK, Olsen TS, Dehlendorff C, Kammersgaard LP. Hemorrhagic and ischemic strokes compared stroke severity, mortality, and risk factors. Stroke. 2009;40(6):2068–72.PubMedGoogle Scholar
  4. Blacquiere DP, Gubitz GJ, Dupere D, McLeod D, Phillips S. Evaluating an organized palliative care approach in patients with severe stroke. Can J Neurol Sci. 2009;36(06):731–4.PubMedGoogle Scholar
  5. Blacquiere D, Bhimji K, Meggison H, Sinclair J, Sharma M. Satisfaction with palliative care after stroke. A prospective cohort study. Stroke. 2013;44:2617–9.PubMedGoogle Scholar
  6. Burton CR, Payne S. Integrating palliative care within acute stroke services: developing a programme theory of patient and family needs, preferences and staff perspectives. BMC Palliat Care. 2012;11(1):1.Google Scholar
  7. Burton CR, Payne S, Addington-Hall J, Jones A. The palliative care needs of acute stroke patients: a prospective study of hospital admissions. Age Ageing. 2010;39(5):554–9.PubMedGoogle Scholar
  8. Campbell BC, Mitchell PJ, Kleinig TJ, Dewey HM, Churilov L, Yassi N, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015;372(11):1009–18.PubMedGoogle Scholar
  9. Carod-Artal FJ, Egido JA. Quality of life after stroke: the importance of a good recovery. Cerebrovasc Dis. 2009;27(Suppl 1):204–14.PubMedGoogle Scholar
  10. Carod-Artal J, Egido JA, Gonzalez JL, de Seijas EV. Quality of life among stroke survivors evaluated 1 year after stroke. Stroke. 2000;12:2995–3000.Google Scholar
  11. Casaubon LK, Boulanger J-M, Glasser E, Blacquiere D, Boucher S, Brown K, et al. Canadian stroke best practice recommendations: acute inpatient stroke care guidelines, update 2015. Int J Stroke. 2016;11(2):239–52.PubMedGoogle Scholar
  12. Choi-Kwon S, Choi JM, Kwon SU, Kang DW, Kim JS. Factors that affect the quality of life at 3 years post-stroke. J Clin Neurol. 2006;2:34–41.PubMedPubMedCentralGoogle Scholar
  13. Cowey E, Smith LN, Stott DJ, McAlpine CH, Mead GE, Barber M, et al. Impact of a clinical pathway on end-of-life care following stroke: a mixed methods study. Palliat Med. 2015;29(3):249–59.PubMedGoogle Scholar
  14. Creutzfeldt CJ, Holloway RG, Walker M. Symptomatic and palliative care for stroke survivors. J Gen Intern Med. 2012;27:853–60.PubMedPubMedCentralGoogle Scholar
  15. Creutzfeldt CJ, Holloway RG, Curtis JR, Palliative Care A. Core competency for stroke neurologists. Stroke. 2015;46(9):2714–9.PubMedPubMedCentralGoogle Scholar
  16. de Boer ME, Depla M, Wojtkowiak J, Visser MC, Widdershoven GA, Francke AL, et al. Life-and-death decision-making in the acute phase after a severe stroke: interviews with relatives. Palliat Med. 2015;29(5):451–7.PubMedGoogle Scholar
  17. De Ryck A, Fransen E, Brouns R, Geurden M, Peij D, Marien P, et al. Post-stroke depression and its multifactorial nature: results from a prospective longitudinal study. J Neurol Sci. 2014;347:159–66.PubMedGoogle Scholar
  18. duPreez AE, Smith MA, Liou JI, Frytak JR, Finch MD, Cleary JF, et al. Predictors of hospice utilization among acute stroke patients who died within thirty days. J Palliat Med. 2008;11(9):1249–57.PubMedPubMedCentralGoogle Scholar
  19. Eastman P, McCarthy G, Brand CA, Weir L, Gorelik A, Le B. Who, why and when: stroke care unit patients seen by a palliative care service within a large metropolitan teaching hospital. BMJ Support Palliat Care. 2013;3(1):77–83.PubMedGoogle Scholar
  20. Eriksson H, Milberg A, Hjelm K, Friedrichsen M. End of life care for patients dying of stroke: a comparative registry study of stroke and cancer. PLoS One. 2016;11(2):e0147694.PubMedPubMedCentralGoogle Scholar
  21. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990–2010: findings from the global burden of disease study 2010. Lancet. 2014;383(9913):245–55.PubMedPubMedCentralGoogle Scholar
  22. Frese A, Husstedt IW, Ringelstein EB, Evers S. Pharmacologic treatment of central post-stroke pain. Clin J Pain. 2006;22:252–60.PubMedGoogle Scholar
  23. Frontera JA, Curtis JR, Nelson JE, Campbell M, Gabriel M, Mosenthal AC, et al. Integrating palliative care into the care of neurocritically ill patients: a report from the improving palliative care in the ICU project advisory board and the center to advance palliative care. Crit Care Med. 2015;43(9):1964–77.PubMedPubMedCentralGoogle Scholar
  24. Gardiner C, Harrison M, Ryan T, Jones A. Provision of palliative and end-of-life care in stroke units: a qualitative study. Palliat Med. 2013;27(9):855–60.PubMedGoogle Scholar
  25. Goyal M, Demchuk AM, Menon BK, Eesa M, Rempel JL, Thornton J, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke. NEJM. 2015;372(11):1019–30.PubMedGoogle Scholar
  26. Hackett ML, Pickles K. Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. Int J Stroke. 2014;9(8):1017–25.PubMedGoogle Scholar
  27. Hackett ML, Anderson CS, House A, Xia J. Interventions for treating depression after stroke. Cochrane Database Syst Rev. 2008;(4):CD003437.  https://doi.org/10.1002/14651858.CD003437.pub3.
  28. Hankey GJ, Jamrozik K, Broadhurst RJ, Forbes S, Anderson CS. Long term disability after first-ever stroke and related prognostic factors in the Perth community stroke study 1989-1990. Stroke. 2002;33:1034–40.PubMedGoogle Scholar
  29. Hemphill JC, Greenberg SM, Anderson CS, Becker K, Bendok BR, Cushman M, et al. Guidelines for the management of spontaneous intracerebral hemorrhage a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015;46(7):2032–60.PubMedGoogle Scholar
  30. Holloway RG, Ladwig S, Robb J, Kelly A, Nielsen E, Quill TE. Palliative care consultations in hospitalized stroke patients. J Palliat Med. 2010;13(4):407–12.PubMedPubMedCentralGoogle Scholar
  31. Holloway RG, Arnold RM, Creutzfeldt CJ, Lewis EF, Lutz BJ, McCann RM, et al. Palliative and end-of-life care in stroke a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(6):1887–916.PubMedGoogle Scholar
  32. Intercollegiate Stroke Working Group. National clinical guideline for stroke 5th edition [Online]. London: Royal College of Physicians; 2016. Available: www.strokeaudit.org/SupportFiles/Documents/Guidelines/2016-National-Clinical-Guideline-for-Stroke-5t-(1).aspx.
  33. Jack C, Jones L, Jack BA, Gambles M, Murphy D, Ellershaw JE. Towards a good death: the impact of the care of the dying pathway in an acute stroke unit. Age Ageing. 2004;33(6):625–6.PubMedGoogle Scholar
  34. Kalra L, Evans A, Perez I, Melbourn A, Pateal A, Knapp M, et al. Training carers of stroke patients: randomized controlled trial. BMJ. 2004;328:1099.PubMedPubMedCentralGoogle Scholar
  35. Kelly AG, Hoskins KD, Holloway RG. Early stroke mortality, patient preferences, and the withdrawal of care bias. Neurology. 2012;79(9):941–4.PubMedPubMedCentralGoogle Scholar
  36. Kim JS, Bashford G, Murphy TK, Martin A, Dror V, Cheung R. Safety and efficacy of pregabalin in patients with central post-stroke pain. Pain. 2011;152(5):1018–23.PubMedGoogle Scholar
  37. Langhorne P, Fearon P, Ronning OM, Kaste M, Palomaki H, Vemmos K, et al. Stroke unit care benefits patients with intracerebral hemorrhage systematic review and meta-analysis. Stroke. 2013;44(11):3044–9.PubMedGoogle Scholar
  38. Leigon G, Boivie J. Central post-stroke pain: a controlled trial of amitriptyline and carbamazepine. Pain. 1989;36:27–36.Google Scholar
  39. Maldonado NJ, Kazmi SO, Suarez JI. Update in the management of acute ischemic stroke. Crit Care Clin. 2014;30(4):673–97.PubMedGoogle Scholar
  40. Mazzocato C, Michel-Nemitz J, Anwar D, Michel P. The last days of dying stroke patients referred to a palliative care consult team in an acute hospital. Eur J Neurol. 2010;17(1):73–7.PubMedGoogle Scholar
  41. Mozaffarian D, Benjamin SJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke Statistics-2015 update: a report from the American Heart Association. Circulation. 2015;131:e29–e322.PubMedGoogle Scholar
  42. Murthy SB, Moradiya Y, Hanley DF, Ziai WC. Palliative care utilization in nontraumatic intracerebral hemorrhage in the United States. Crit Care Med. 2016;44:575–82.PubMedGoogle Scholar
  43. National Stroke Foundation. Clinical guidelines for stroke management. Melbourne; 2010.Google Scholar
  44. Neuberger J, Guthrie C, Aaronovitch D. More care, less pathway: a review of the Liverpool care pathway. London: Department of Health; 2013.Google Scholar
  45. Ntlholang O, Walsh S, Bradley D, Harbison J. Identifying palliative care issues in inpatients dying following stroke. Ir J Med Sci. 2016;185:741–4.PubMedGoogle Scholar
  46. Parry-Jones AR, Paley L, Bray BD, Hoffman AM, James M, Cloud GC, et al. Care-limiting decisions in acute stroke and association with survival: analyses of UK national quality register data. Int J Stroke. 2016;11(3):321–31.PubMedGoogle Scholar
  47. Payne S, Burton C, Addington-Hall J, Jones A. End-of-life issues in acute stroke care: a qualitative study of the experiences and preferences of patients and families. Palliat Med. 2010;24(2):146–53.PubMedGoogle Scholar
  48. Raffaeli W, Minella CE, Magnani F, Sarti D. Population-based study of central post-stroke pain in Rimini District, Italy. J Pain Res. 2013;6:705–11.PubMedPubMedCentralGoogle Scholar
  49. Robinson RG, Jorge RE. Post-stroke depression: a review. Am J Psychiatry. 2016;173(3):221–31.PubMedGoogle Scholar
  50. Rogers A, Addington-Hall J. Care of the dying stroke patients in the acute setting. J Res Nurs. 2005;10(2):153–67.Google Scholar
  51. Saposnik G, Hill MD, O’Donnell M, Fang J, Hachinski V, Kapral MK. Variables associated with 7-day, 30-day, and 1-year fatality after ischemic stroke. Stroke. 2008;39(8):2318–24.PubMedGoogle Scholar
  52. Simmons BB, Parks SM. Intracerebral hemorrhage for the palliative care provider: what you need to know. J Palliat Med. 2008;11(10):1336–9.PubMedGoogle Scholar
  53. Smith EE, Hassan KA, Fang J, Selchen D, Kapral MK, Saposnik G, Investigators of the Registry of the Canadian Stroke Network, Stroke Outcome Research Canada (SORCan) Working Group. Do all ischemic stroke subtypes benefit from organized inpatient stroke care? Neurology. 2010a;75(5):456–62.PubMedPubMedCentralGoogle Scholar
  54. Smith EE, Shobha N, Dai D, Olson DM, Reeves MJ, Saver JL, et al. Risk score for in-hospital ischemic stroke mortality derived and validated within the get with the guidelines–stroke program. Circulation. 2010b;122(15):1496–504.PubMedGoogle Scholar
  55. Stevens T, Payne SA, Burton C, Addington-Hall J, Jones A. Palliative care in stroke: a critical review of the literature. Palliat Med. 2007;21(4):323–31.PubMedGoogle Scholar
  56. van Heugten C, Visser-Meily A, Post M, Lindeman E. Care for carers of stroke patients: evidence-based clinical practice guidelines. J Rehabil Med. 2006;38(3):153–8.PubMedGoogle Scholar
  57. Vartiainen N, Perchet C, Magnin M, Creac’h C, Convers P, Nighoghossian N, et al. Thalamic pain: anatomical and physiological indices of prediction. Brain. 2016;139(3):708–22.PubMedGoogle Scholar
  58. Wendler D, Rid A. Systematic review: the effect on surrogates of making treatment decisions for others. Ann Intern Med. 2011;154(5):336–46.PubMedGoogle Scholar
  59. World Health Organisation. The top 10 causes of death. 2014. http://www.who.int/mediacentre/factsheets/fs310/en/. Accessed 18 Nov 2016.
  60. Young AJ, Rogers A, Dent L, Addington-Hall JM. Experiences of hospital care reported by bereaved relatives of patients after a stroke: a retrospective survey using the VOICES questionnaire. J Adv Nurs. 2009;65(10):2161–74.PubMedGoogle Scholar
  61. Zahuranec DB, Brown DL, Lisabeth LD, Gonzales NR, Longwell PJ, Smith MA, et al. Early care limitations independently predict mortality after intracerebral hemorrhage. Neurology. 2007;68(20):1651–7.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Palliative CareBarwon HealthNorth GeelongAustralia
  2. 2.Department of Palliative and Supportive CareRoyal Melbourne Hospital/Melbourne HealthParkvilleAustralia

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