Integrating Palliative Care into the Neurointensive Care Unit

Excerpt

Patients with severe acute brain injury (SABI), including traumatic brain injuries, typically present acutely neurologically devastated, with uncertain prognosis, and are unable to participate in crucial treatment decisions. To incorporate palliative care for patients with SABI, health care providers must consider the unique care needs for both the patient and their family members and potential barriers to meeting those needs. In this issue of Neurocritical Care, Dolmans et al. [1] make a strong argument regarding the need for neuropalliative care in the intensive care unit (ICU) setting. For example, altered communication abilities and decreased levels of consciousness due to the brain injury, sedation, or both, impact the assessment of a patient’s distress or discomfort. The authors also describe barriers to incorporating neuropalliative care in the ICU, including prognostic uncertainty, lack of advance directives, and misconceptions regarding palliative care. To address these barriers, the authors endorse a structured palliative care program and education to effectively communicate with patients and family members, as supported by the literature [1]. …