| Popis: |
Integration of palliative care with heart failure has historically been inadequate partly due to poor prognostication. The advent of mechanical circulatory support and LVAD destination therapy identified a new patient population that may benefit from palliative care. The palliative care team assists patients and caregivers prior to receiving mechanical circulatory support through preparedness planning. Preparedness planning differs from traditional advance care planning due to its specific focus on possible treatment complications including infection, cerebrovascular events, device malfunction, and bleeding. A proficient understanding of these complications is necessary to effectively prepare patients before implantation as well as support them in the event they occur. Palliative care may also help with transitions of care at the end of life. Communication with patients, family members, and the medical team during these transitions is vital. Most patients with mechanical circulatory support die in the hospital, and palliative providers must be comfortable with VAD deactivation. Greater palliative care involvement along the continuum of care may lead to a higher rate of hospice referral to better support patient and families at the end of life. |
