Conflict of interest: The authors declare no potential conflict of interest.
Life after stroke – is palliative care relevant?
A better understanding of illness trajectories after stroke may help clinicians identify patients for a palliative approach to care.
Article first published online: 23 JUL 2013
© 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization
International Journal of Stroke
Volume 8, Issue 6, pages 447–448, August 2013
How to Cite
Mead, G. E., Cowey, E. and Murray, S. A. (2013), Life after stroke – is palliative care relevant?. International Journal of Stroke, 8: 447–448. doi: 10.1111/ijs.12061
- Issue published online: 23 JUL 2013
- Article first published online: 23 JUL 2013
Only about 50% of people who have a stroke survive to five-years. Clinicians should identify those most at risk of dying, and gradually integrate palliative care. Such holistic and anticipatory care will be of benefit to patients and their family carers; should reduce futile treatments, medications, or unsuccessful resuscitation attempts; and help more people die how and where they choose. Research is exploring how best to provide palliative and end-of-life care in acute stroke units, but how best to improve holistic, ongoing care in the community is poorly understood. The concept of fluctuating illness trajectories might help clinicians meet the multidimensional needs of stroke survivors at different time points. ‘Illness trajectory’ research in cancer has suggested that social decline mirrors the physical decline, while psychological and existential distress tended to be most acute at diagnosis, returning home after treatment, disease recurrence, and in the last days. Further research is needed to explore how best to provide palliative care at different stages of the ‘stroke journey’, and the nature of illness trajectories after stroke.