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Palliative Care in Neurology

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Front. Neurol. | doi: 10.3389/fneur.2019.00164

Palliative Care for stroke patients and their families: barriers for implementation

  • 1Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
  • 2Klinikum Darmstadt, Germany

Stroke is a leading cause of death, disability and symptom burden worldwide afflicting both patients and families in various dimensions comprising physical, emotional, social and existential aspects. Thereby stroke qualifies as eligible for palliative care (PC) support in accordance with the contemporary definition of PC published by the WHO in 2002 and reflected throughout many entities. Core competencies of PC comprise critical appraisal of various treatment options and discussing therapeutic goals openly and respectfully with patients, families and caregivers; furthermore a structured approach to palliative care needs and amelioration of symptom burden is essential.
Nevertheless PC in stroke is to date mainly restricted to care for dying patients in life limiting complications of acute stroke. An approach when to initiate PC for stroke patients and which symptoms to screen for as well as an integrated concept for PC in stroke care are lacking. Hence, PC for stroke patients is currently rather an emergency solution and retains the association with death and dying. Instead PC as an integrated approach to holistic stroke care is to focus on quality of life and living. We identified key aspects of PC in stroke care and current barriers to implementation.

Keywords: Stroke, Palliative Care, Palliative care needs, caregiver burden, integration

Received: 16 Aug 2018; Accepted: 07 Feb 2019.

Edited by:

Raymond Voltz, Zentrum für Palliativmedizin, Uniklinik Köln, Germany

Reviewed by:

Ryan M. Martin, University of California, Davis, United States
Deepa Bhupali, University of Illinois at Chicago, United States  

Copyright: © 2019 Steigleder, Kollmar and Ostgathe. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Tobias Steigleder, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany,