What is what? From a palliative care approach to specialized palliative care in heart failure management

Abstract

This article refers to 'The impact of palliative care on clinical and patient-centred outcomes in patients with advanced heart failure: a systematic review of randomized controlled trials' by N. Sahlollbey et al., published in this issue on pages 2340-2346.

Palliative key aspects are of importance for symptom relief during the last week of life in patients with heart failure

“…discuss in a recent editorial comment the unclarity of terms used in palliative care and argue that misunderstandings about the terms might be present amongst professionals who provide care for patients with HF and their family members, contributing to a lack of palliative care. The authors thus suggest that there still might be worries and uncertainty about the term palliative care 31 . Leaning towards the models of Sawatzky et al 29 .…”

“…The authors thus suggest that there still might be worries and uncertainty about the term palliative care. 31 Leaning towards the models of Sawatzky et al 29 and Touzel and Shadd, 30 palliative care can be understood as care applied in longer periods for patients with HF and not as care only for patients who are imminently dying.…”

Elements of Integrated Palliative Care in Chronic Heart Failure Across the Care Continuum: A Scoping Review

“…The results demonstrate that the primary method of integrating palliative care in the context of CHF was to deliver care which was tailored according to the individuals' needs and preferences [13][14][15][16][17][18][19][20][21]. Patient-centred care involves addressing physical symptoms [14,15,17,[22][23][24][25][26][27], psychosocial, psychological and spiritual issues [5,17,21,25,26,[28][29][30][31][32]. Integrating palliative care in CHF entails engagement in future care planning including deactivation of defibrillator [33], and shared decision making through patient-provider communication [13,24,[34][35][36][37][38][39][40][41][42] and involvement of the carer in planning and managing treatment expectations [27,43].…”

Palliative care: Essential support for patients with heart failure in the COVID-19 pandemic

“…The need to acknowledge the prognostic ambiguity intrinsic to HF, particularly in the COVID-19 context, and to undertake difficult conversations about end of life preferences, requires all relevant professionals to adopt a palliative approach, combining objectivity with compassion and truthfulness. 11 Emotional and sociocultural barriers may have to be navigated to facilitate valid shared decision making about future interventions. 12 Discussions regarding ceilings of care or withdrawal of treatment should take into account the HF patients’ current physiological status and pre-existing quality of life, any formally enacted advance directives or statements, and their personal wishes and values, including an exploration of their cultural norms and spiritual beliefs.…”