[Invasive and non-invasive ventilation in conflict with best palliative care in severe COPD].
This example of an 80-year-old patient with severe lung disease and respiratory failure demonstrates the difficult relationship between the patient's needs, physical symptoms, and social problems. This man decides after a prolonged and difficult in-patient treatment actively for home ventilation rather than die of respiratory failure. He opts for tracheostomy and invasive ventilation because he cannot handle non-invasive mask-ventilation sufficiently by himself. It requires professional communication and support to gain the acceptance of family and caregivers for home ventilation. A survey of existing data on end of life decision-making in end-stage lung disease is given.
Interne Abteilung, Palliativkonsiliardienst/mobiles Palliativteam, Landesklinikum Waldviertel Zwettl, Zwettl, Austria. martin.mikesch@zwettl.lknoe.at
Martin
M
Mikesch
Peter
P
Reichenpfader
D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D003131:Combined Modality Therapy; D003142:Communication; D003220:Conflict, Psychological; D045422:Continuous Positive Airway Pressure / Q000523:psychology; D004417:Dyspnea / Q000523:psychology / Q000628:therapy*; D019317:Evidence-Based Medicine; D018575:Home Care Services, Hospital-Based; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000379:methods* / Q000523:psychology; D010348:Patient Care Team; D010358:Patient Participation / Q000523:psychology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology; D012131:Respiratory Insufficiency / Q000523:psychology / Q000628:therapy*; D013727:Terminal Care / Q000379:methods; D014140:Tracheotomy / Q000523:psychology