title: Palliative care and neurology: time for a paradigm shift.
abstract: Palliative care is an approach to the care of patients and families facing progressive and chronic illnesses that focuses on the relief of suffering due to physical symptoms, psychosocial issues, and spiritual distress. As neurologists care for patients with chronic, progressive, life-limiting, and disabling conditions, it is important that they understand and learn to apply the principles of palliative medicine. In this article, we aim to provide a practical starting point in palliative medicine for neurologists by answering the following questions: (1) What is palliative care and what is hospice care? (2) What are the palliative care needs of neurology patients? (3) Do neurology patients have unique palliative care needs? and (4) How can palliative care be integrated into neurology practice? We cover several fundamental palliative care skills relevant to neurologists, including communication of bad news, symptom assessment and management, advance care planning, caregiver assessment, and appropriate referral to hospice and other palliative care services. We conclude by suggesting areas for future educational efforts and research.
authors.affiliation: From the Departments of Neurology and Psychiatry (I.B., B.K.) and Internal Medicine (J.K.), University of Colorado Anschutz Medical Campus, Aurora; and Department of Neurology (J.M.), University of Alberta, Edmonton, Canada.
authors.forename: Isabel
authors.initials: I
authors.lastname: Boersma
authors.affiliation: From the Departments of Neurology and Psychiatry (I.B., B.K.) and Internal Medicine (J.K.), University of Colorado Anschutz Medical Campus, Aurora; and Department of Neurology (J.M.), University of Alberta, Edmonton, Canada.
authors.forename: Janis
authors.initials: J
authors.lastname: Miyasaki
authors.affiliation: From the Departments of Neurology and Psychiatry (I.B., B.K.) and Internal Medicine (J.K.), University of Colorado Anschutz Medical Campus, Aurora; and Department of Neurology (J.M.), University of Alberta, Edmonton, Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Kutner
authors.affiliation: From the Departments of Neurology and Psychiatry (I.B., B.K.) and Internal Medicine (J.K.), University of Colorado Anschutz Medical Campus, Aurora; and Department of Neurology (J.M.), University of Alberta, Edmonton, Canada. benzi.kluger@ucdenver.edu.
authors.forename: Benzi
authors.initials: B
authors.lastname: Kluger
mesh_terms: D006801:Humans; D009422:Nervous System Diseases / Q000175:diagnosis / Q000628:therapy*; D009462:Neurology / Q000379:methods / Q000639:trends*; D010166:Palliative Care / Q000379:methods / Q000639:trends*; D010819:Physician's Role