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Semin Neurol
DOI: 10.1055/s-0044-1787809
Review Article

End-of-Life and Hospice Care in Neurologic Diseases

Claudia Z. Chou
1   Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, Minnesota
,
Elyse A. Everett
2   Department of Medicine, Washington University in St. Louis, St. Louis, Missouri
3   Department of Neurology, Washington University in St. Louis, St. Louis, Missouri
,
Jessica McFarlin
4   Department of Neurology, University of Kentucky, Lexington, Kentucky
,
Usha Ramanathan
5   Division of Neurology, University of Toronto, Toronto, Ontario, Canada
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Abstract

The care of a patient with neurologic disease at end-of-life requires expertise in addressing advance care planning, hospice, symptom management, and caregiver support. Neurologists caring for patients with advanced neurologic disease often identify changes in disease trajectory, functional status, or goals of care that prompt discussions of advance care planning and hospice. Patients nearing end-of-life may develop symptoms such as dyspnea, secretions, delirium, pain, and seizures. Neurologists may be the primary clinicians managing these symptoms, particularly in the hospitalized patient, though they may also lend their expertise to non-neurologists about expected disease trajectories and symptoms in advanced neurologic disease. This article aims to help neurologists guide patients and caregivers through the end-of-life process by focusing on general knowledge that can be applied across diseases as well as specific considerations in severe stroke and traumatic brain injury, amyotrophic lateral sclerosis, Parkinson's disease, and dementia.

Keywords

end-of-life - hospice - neuropalliative - palliative care - palliative medicine


Publication History

Article published online:
25 June 2024

© 2024. Thieme. All rights reserved.

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