A comprehensive approach to palliative care in neurological pathology
https://doi.org/10.30629/2658-7947-2023-28-1-67-72
Abstract
Palliative care for neurological patients is an approach to patient care and assistance to their families facing chronic, progressive, life-limiting and disabling conditions. The peculiarity of palliative care in neurology is due to the signifi cant duration of the late stages of many neurological diseases and the distinctive features of some diseases (cognitive disorders, mental disorders, speech disorders, pelvic organ dysfunction, paresis, convulsions, contracture development, etc.), as well as the presence of concomitant common symptoms (eating disorders, pain, bedsores, respiratory failure, etc.). The symptoms developing in the advanced stages of neurological diseases requiring palliative care are described. Drug and non-drug methods of treatment are described, measures aimed at improving the quality of life and preventing complications are considered. The features of pharmacotherapy, taking into account their interaction with drugs for the treatment of concomitant pathology, are considered.
About the Authors
N. V. OrlovaRussian Federation
Moscow
E. Y. Soloviova
Russian Federation
Moscow
T. I. Bonkalo
Russian Federation
Moscow
S. V. Shmeleva
Russian Federation
Moscow
M. V. Soloviova
Russian Federation
Moscow
References
1. Provinciali L., Carlini G., Tarquini D., Defanti C.A., Veronese S., Pucci E. Need for palliative care for neurological diseases. Neurol Sci. 2016;37(10):1581–7. doi: 10.1007/s10072-016-2614-x
2. Higginson I.J., Gao W., Saleem T.Z. et al. Symptoms and quality of life in late stage Parkinson syndromes: a longitudinal community study of predictive factors. PLoS One. 2012;7(11):e46327. doi: 10.1371/journal.pone.0046327
3. Congedo M., Causarano R.I., Alberti F., Chaudhuri K.R., Burman R., McCrone P., Leigh P.N. Bioethics and Palliative Care in Neurology Study Group of Italian Society of Neurology. Ethical issues in end of life treatments for patients with dementia. Eur. J. Neurol. 2010;17(6):774–9. doi: 10.1111/j.1468-1331.2010.02991.x
4. Boersma I., Miyasaki J., Kutner J., Kluger B. Palliative care and neurology: time for a paradigm shift. Neurology. 2014;83(6):561– 7. doi:10.1212/WNL.0000000000000674
5. Borasio G.D. The role of palliative care in patients with neurological diseases. Nat. Rev. Neurol. 2013;9(5):292–5. doi: 10.1038/nrneurol.2013.49
6. Turner-Stokes L., Sykes N., Silber E., Khatri A., Sutton L., Yuong E. From diagnosis to death: exploring the interface between neurology, rehabilitation and palliative care in managing people with long-term neurological conditions. Clin. Med. (Lond.). 2007;7(2):129–36. doi: 10.7861/clinmedicine.7-2-129
7. Mitchell S.L., Kiely D.K., Hamel M.B. Dying with advanced dementia in the nursing home. Arch. Intern. Med. 2004;164(3):321–6. doi: 10.1001/archinte.164.3.321
8. Chahine L.M., Malik B., Davis M. Palliative care needs of patients with neurologic or neurosurgical conditions. Eur. J. Neurol. 2008;15(12):1265–72. doi: 10.1111/j.1468-1331.2008.02319.x
9. Creutzfeldt C.J., Kluger B., Kelly A.G., Lemmon M., Hwang D., Galifi anakis N.B. et al. Neuropalliative care: Priorities to move the fi eld forward. Neurology. 2018;91(5):217–226. doi: 10.1212/WNL.0000000000005916
10. Song J., Youn J., Huh Y.E. Motor and Non-motor Symptoms Associated with Exercise Behavior in Parkinson’s Disease Patients: Factors Diff er between Patients With and Without Postural Instability. Front Neurol. 2021;12:772391. doi: 10.3389/fneur.2021.772391
11. Klinicheskie rekomendacii MZ RF. Rasseyannyj skleroz. 2018:164 p. (In Russ.)]. https://diseases.medelement.com/
12. Schwab R.S, England A.C. Projection Technique for Evaluating Surgery in Parkinson’s Disease. In: Third Symposium on Parkinson’s Disease, Gillingham J.F. and Donaldson I.M.L., eds. Edinburgh, Livingstone, 1969:152–157 ID: 80169192 https://www.semanticscholar.org/paper/
13. Hoehn M.M., Yahr M.D. Parkinsonism: onset, progression and mortality. Neurology. 1967;17(5):427–42. doi: 10.1212/wnl.17.5.427
14. Mahoney F., Barthel D. W. Functional evaluation; the Barthel index. A simple index of the independence useful in scoring improvement in the rehabilitation of the chronically ill. Maryland state medical journal. 1965. ID: 80218831 https://www.semanticscholar.org/author
15. Belkin A.A., Rudnik E.N., Belkin V.A. et al. Optimization of StepBy-Step Care for Patients in Intensive Care Units Based on Grade 6 of the Rehabilitation Routing Scale. Physical and rehabilitation medicine, medical rehabilitation. 2021;3(1):142–148. doi: 10.36425/rehab64082
16. Diagnostika i lechenie disfagii pri zabolevaniyah central’noj nervnoj sistemy. Klinicheskie rekomendacii. Utverzhdeno profi l’noj komissiej po medicinskoj reabilitacii Ekspertnogo Soveta MZ RF. 2013:38 p. (In Russ.)]. https://diseases.medelement.com/disease
17. American Geriatrics Society Ethics Committee and Clinical Practice and Models of Care Committee. American Geriatrics Society feeding tubes in advanced dementia position statement. J. Am. Geriatr. Soc. 2014;62(8):1590–3. doi: 10.1111/jgs.12924
18. Thomas S., MacMahon D. Parkinson’s disease, palliative care and older people: Part 1. Nurs. Older People. 2004;16(1):22–6. doi: 10.7748/nop2004.03.16.1.22.c2290
19. Golla H., Galushko M., Pfaff H., Voltz R. Unmet needs of severely aff ected multiple sclerosis patients: the health professionals’ view. Palliat Med. 2012;26(2):139–51. doi: 10.1177/0269216311401465
20. Ahuja C.S., Wilson J.R., Nori S. et al. Traumatic spinal cord injury. Nat. Rev. Dis. Primers. 2017;3:17018. doi: 10.1038/nrdp.2017.18
21. van den Berg M.E.L, Castellote J.M., Pedro-Cuesta J., Mahillo-Fernandez I. Survival after spinal cord injury: a systematic review. J. of Neurotrauma. 2010;27(8):1517–28. doi:10.1089/neu.2009.1138
22. Payne S., Burton C., Addington-Hall J., Jones A. End-of-life issues in acute stroke care: a qualitative study of the experiences and preferences of patients and families. Palliat. Med. 2010; 24(2):146–53. doi: 10.1177/0269216309350252
23. Gorelik S.G., Il’nickij A.N., Proshchaev K.I. i dr. Oprosniki i shkaly v gerontologii i geriatrii GERONTOLOGY Scientifi c Journal. 2021;9(1):90 p. (In Russ.)]. http://gerontology.su
24. Provinciali L., Carlini G., Tarquini D. et al. Need for palliative care for neurological diseases. Neurol. Sci. 2016;37(10):1581–7. doi: 10.1007/s10072-016-2614-x
25. Payne S., Burton C., Addington-Hall J., Jones A. End-of-life issues in acute stroke care: a qualitative study of the experiences and preferences of patients and families. Palliat. Med. 2010;24(2):146–53. doi: 10.1177/0269216309350252
26. Mitchell S.L., Teno J.M., Kiely D.K. et al. The clinical course of advanced dementia. N. Engl. J. Med. 2009;361(16):1529–38. doi: 10.1056/NEJMoa0902234
27. Gove D., Sparr S., Dos Santos Bernardo A.M., Cosgrave M.P., Jansen S., Martensson B., Pointon B., Tudose C., Holmerova I. Recommendations on end-of-life care for people with dementia. J. Nutr. Health Aging. 2010;14(2):136–9. doi: 10.1007/s12603-0090229-0
28. Kahveci K., Dinçer M., Doger C., Yaricı A.K. Traumatic brain injury and palliative care: a retrospective analysis of 49 patients receiving palliative care during 2013–2016 in Turkey. Neural Regen. Res. 2017;12(1):77–83. doi: 10.4103/1673-5374.198987
29. Solari A., Giordano A., Grasso M.G. et al. PeNSAMI Project. Home-based palliative approach for people with severe multiple sclerosis and their carers: study protocol for a randomized controlled trial. Trials. 2015;16:184. doi: 10.1186/s13063-015-0695-0 Erratum in: Trials. 2016;17:89. Erratum in: Trials. 2017;18(1):35.
30. Walbert T., Khan M. End-of-life symptoms and care in patients with primary malignant brain tumors: a systematic literature review. J. Neurooncol. 2014;117(2):217–24. doi: 10.1007/s11060-014-13936
31. Agar M.R., Lawlor P.G., Quinn S. et al. Effi cacy of oral risperidone, haloperidol, or placebo for symptoms of delirium among patients in palliative care: a randomized clinical trial. JAMA Intern. Med. 2017;177:34–42. doi: 10.1001/jamainternmed.2016.7491/
32. Veronese S., Gallo G., Valle A. et al. Specialist palliative care improves the quality of life in advanced neurodegenerative disorders: NE-PAL, a pilot randomised controlled study. BMJ Support Palliat. Care. 2017;7(2):164–172. https://doi.org/10.1136/bmjspcare-2014-000788
Review
For citations:
Orlova N.V., Soloviova E.Y., Bonkalo T.I., Shmeleva S.V., Soloviova M.V. A comprehensive approach to palliative care in neurological pathology. Russian neurological journal. 2023;28(1):67-72. (In Russ.) https://doi.org/10.30629/2658-7947-2023-28-1-67-72