The health care community should integrate palliative care into all aspects of post-stroke treatments, according to a new scientific statement from the American Heart Association (AHA).
This should include interventions to address psychosocial health, navigating the health care system and preparation for end-of-life care when necessary, the statement indicated. The paper appeared in a recent issue of the peer-reviewed journal Stroke.
“Stroke is often thought of as an event that is over quickly, but that is not true,” said Dr. Claire J. Creutzfeldt, chair of the writing group and associate professor of neurology at the University of Washington in Seattle, in a AHA statement. “Even though the majority of strokes are not immediately life-threatening, every stroke is life-altering, and every stroke requires high-quality, person-centered care. Integrating palliative care principles into stroke care is fundamental for all patients and at every stage after a stroke.”
Nearly 800,000 people per year in the United States suffer a stroke, the AHA reported. Of those, about 160,000 die, making stroke the fifth-leading cause of death in the nation. Stroke is also a leading cause of disability.
Key palliative principles that should be incorporated into routine stroke care include improved communication about prognosis and goals of care, strategies to address patients’ psychosocial needs and a comprehensive assessment of symptoms, among others.
The scientific statement also underscored the need to address inequities in the health care system pertaining to stroke care, particularly those centered around socioeconomic status, race and ethnicity.
The new document complements the AHA’s 2014 Scientific Statement on Palliative and End-of-Life Care in Stroke, which discussed core palliative care competencies and skills for health care professionals who treat stroke patients. It also follows similar statements calling for greater integration of palliative care into treatments for cardiac conditions, such as heart failure.
“It’s essential to recognize the impact of illness and disability on someone’s quality of life and understand that treatment decisions will vary from patient to patient, based on their values, their beliefs and their culture,” Creutzfeldt said. “An individualized and culturally sensitive approach to assessment and management is always best. Additionally, the palliative care needs of patients and their families or care partners after a stroke fluctuate over the course of their illness based on events, symptoms, changes in function and stage of the illness.”
