Palliative care of the patient with a stroke

Dr Rodica Sorina Pop (a)(f), Dr Sorina Livia Pop (b)(f), Dr. Codruţa Mărginean (b)(f), Dr Emil Onaca (b)(f), Dr Radu Revnic (d)(f), Dr Bianca Cojan (d)(f), Dr Mira Florea (e)(f)

a): MD, PhD, family medicine, geriatric-gerontology, palliative care competence, lecturer, “Cornel Igna” Municipal Hospital, Câmpia Turzii, Romania,
b): MD, PhD, internal medicine, senior lecturer
c): MD, PhD, family medicine, senior lecturer, individual practice in family medicine, Cluj Napoca, Romania,
d): MD, family medicine, lecturer, individual practice in family medicine, Cluj Napoca, Romania,
e): MD, PhD, family medicine, senior lecturer
f): Department of Family Medicine, University of Medicine and Pharmacy Cluj Napoca, Romania

Abstract

Introduction:
Vascular cerebral accident, stroke, is considered the main cause of disability in adults because more than 20% of patients hospitalized with this disease is sent home and needs nursing care and 30% remain disabled and needs palliative care.

Material and method:
The literature has been reviewed to identify the actions taken for controlling symptoms during the care process.

Discussions, conclusions:
The holistic evaluation of patients is pursued in the four areas: physical, psycho-emotional, social and spiritual. Palliative care should be centred on the patient care unit with his or her family, and the role of coordinator of this process is for the family doctor due to its proximity and accessibility.

The management of physical symptoms involves control of post stroke central pain, painful hemiplegic shoulder syndrome, fatigue, comity, incontinence, obstructive sleep apnoea.

Management of psychic symptoms involves controlling anxiety, depression, delirium and emotional instability.

Attention is also paid to identify and treat social and spiritual needs.

Key words: palliative care, stroke, symptom management

(Full text in Romanian language)

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