Palliative and end-of-life care for people with stroke

Abstract

Stroke is a devastating illness. Significant progress has been made in the prevention, acute treatment and rehabilitation of stroke. Yet many people still die from stroke. The role of palliative and end-of-life care for stroke has received considerably less attention. This review presents an overview of the current understanding of palliative and end-of-life care for people with stroke. The impact of stroke is wide-ranging and long lasting. It affects both patients and those who become their caregivers. Those who are dying from stroke experience a similar symptom profile to many other dying people. Palliative care services involved in care of stroke patients are more frequently involved in issues related to communication and difficult decisions related to food and fluids. Caregivers have significant needs, particularly around information provision, communication and involvement in, or consultation about, decision-making. Those who survive the immediate aftermath of a stroke are often left with significant psychological and social limitations in addition to physical disability. It is clear that patients with stroke have palliative care needs. Palliative and end-of-life care services can contribute to the care of people with stroke, and their families, but the way in which stroke and palliative care services should interlink remains unclear.