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Introducing or transitioning patients to palliative care 

Introducing or transitioning patients to palliative care

Chapter:
Introducing or transitioning patients to palliative care
Author(s):

A. Katalin Urban

, Josephine M. Clayton

, and David W. Kissane

DOI:
10.1093/med/9780198736134.003.0021
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date: 23 April 2017

Effective communication between patients, families, and healthcare professionals is critical to transitioning to a palliative approach and enables patients and their families to adjust to the life-limiting nature of the illness, avoid unnecessary and invasive treatments, accomplish remaining life goals, and prepare for death. The PREPARED acronym provides a framework to guide clinicians in discussing the transition to a palliative approach in a way that respects the patient’s preferences, provides empathy, and helps sustain realistic hope. Settings of steadily advancing disease burden, the need to change or cease disease-directed therapies, the need for specialist palliative care services, and when the patient approaches the terminal phase of life are considered. Benefits in early referral to palliative care and models of parallel care are discussed. Clinical scenarios for simulated patient encounters in communication skills training are provided as an online appendix.

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