Abstract
Palliative care aims to improve the quality of life for patients and their families facing problems associated with life-threatening illness. It strives to reduce distress associated with their illness through the early identification, assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual (Braun et al. Circulation 134(11):e198–e225, 2016; Palliative care: World Health Organization, 2017). Traditional palliative care is counter-culture to cardiac care. Surgical cardiac care health systems shy from accepting death as a potential appropriate outcome to a trial of cardiac surgery and palliative care teams shy from providing support to ameliorate symptoms for patients striving for survival in a post cardiac surgery (Schulz and Novick, Semin Cardiothorac Vasc Anesth 17:240–248, 2013). Palliative care and cardiac care programs are not yet aligned for a seamless integration of care. Fortunately, collaboration between palliative care and cardiac care teams is strengthening. This collaboration is driven in part by decisive policy statements and guidelines (Braun et al. Circulation 134(11):e198–e225, 2016; Ventricular Assist Devices (NCD 20.9.1). United Healthcare; 2016 October 12) and palliative care literature (see references in this chapter), that call for the integration of palliative care within cardiac care. Integration of palliative care and cardiac care is evolving. This chapter discusses the advancing role of palliative care support within the cardiac care team. Through the lens of a composite case vignette, we will discuss patient needs such as symptoms, communication and decision-making, as well as system opportunities and barriers to integrating palliative care on the cardiac care team.
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The academic support by the Department of Anesthesia and Perioperative Medicine, and Clinical Neurological Sciences, Western University.
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Schulz, V., Gofton, T. (2021). Palliative Care Post Cardiac Surgery. In: Cheng, D.C., Martin, J., David, T. (eds) Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-47887-2_58
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