Palliative care for patients with communication and cognitive difficulties

摘要: Abstract Objective To help increase the confidence of both caregivers and clinicians in providing palliative care to adults with intellectual developmental disabilities (IDD) using an easy-to-follow framework improve overcome barriers effective this population. Quality evidence A literature review was conducted explore recent best address these needs allow for a focused opportunity consider details implementing clinical practice guidelines context. Evidence ranges from level I III. Main message Pain psychological emotional distress are important issues individuals IDD, as they can be difficult assess measure, often present atypically, especially those limited communication skills. Further, little is known about end-of-life adult population living community residences. The patient, caregiver, clinician experiences exposed considerable barriers, including incorrect assumptions patients’ capacity understand discomfort open communication. This has resulted exclusion IDD their own care, which proven harmful. Maximizing time familiar surroundings establishing trust continuity crucial. Sometimes trial error empiric use comfort medications necessary, but mitigated careful examination patterns judicious diagnostic testing. It always integrate approach into existing pattern care. Conclusion validated tools recommendations provided will assist communication, symptom interpretation, treatment decisions, advanced planning, addressing grief, considerations