Handb Clin Neurol. 2022;190:175-193. doi: 10.1016/B978-0-323-85029-2.00003-8.ABSTRACTPrognosticating is central to primary palliative care in neurology. Many neurologic diseases carry a high burden of troubling symptoms, and many individuals consider health states due to neurologic disease worse than death. Many patients and families report high levels of need for information at all disease stages, including information about prognosis. There are many barriers to communicating prognosis including prognostic uncertainty, lack of training and experience, fear of destroying hope, and not enough time. Developing the right mindset, tools, and skills can improve one’s ability to formulate and communicate prognosis. Prognosticating is subject to many…
Origen: Prognostication in neurology – PubMed

Handb Clin Neurol. 2022;190:149-161. doi: 10.1016/B978-0-323-85029-2.00001-4.ABSTRACTDespite the use of aggressive multimodality therapies, the prognosis of brain tumor patients remains poor. Tumors of glial origin typically have the worst prognosis, with a predicted median survival of 12-15months for glioblastoma multiforme (WHO grade IV) and 2-5years for anaplastic glioma (WHO grade III). Palliative care problems and needs in patients with primary and secondary brain tumors are significantly different, both due to different trajectory of disease and to variable prognosis which in metastatic brain tumors is related to the natural history of primary tumors. This chapter describes the complex interactions influencing communication and…
Origen: Prognostication in brain tumors – PubMed

Handb Clin Neurol. 2022;190:163-174. doi: 10.1016/B978-0-323-85029-2.00009-9.ABSTRACTDementia is a progressive, irreversible illness and leading global cause of death defined by cognitive and subsequent functional decline. Current treatments have limited impact on mortality. In this chapter, we discuss the trajectory of dementia and its variability, markers associated with poorer prognosis (such as poor nutrition, pneumonia, comorbid conditions), the impact of hospitalization on prognosis, and current models of end-of-life palliative care/hospice eligibility (with the use of the Functional Assessment Staging tool and other markers). We then discuss strategies to discuss prognosis with patients and their healthcare proxies using a mental model (Ask, Discover,…
Origen: Prognostication in dementia – PubMed

Handb Clin Neurol. 2022;190:105-125. doi: 10.1016/B978-0-323-85029-2.00011-7.ABSTRACTLife-limiting and life-threatening neurologic conditions often progress slowly. Patients live with a substantial symptom burden over a long period of time, and there is often a high degree of functional and cognitive impairment. Because of this, the most appropriate time to initiate neuropalliative care is often difficult to identify. Further challenges to the incorporation of neuropalliative care include communication barriers, such as profound dysarthria or language impairments, and loss of cognitive function and decision-making capacity that prevent shared decision making and threaten patient autonomy. As a result, earlier initiation of at least some components of…
Origen: When to initiate palliative care in neurology – PubMed

Hay que buscar a ese hombre… o a esa mujer  Diario Siglo XXI
Origen: Hay que buscar a ese hombre… o a esa mujer – Diario Siglo XXI – Google News