Conversation guidelines for improving quality of palliative care services in ICU

Abstract

End-of-life patients in the intensive care unit (ICU) are critically ill with threat to vital organ function. If function of these organs do not recover, most patients will enter the final stage of life. ICU patients may receive aggressive life sustaining support measures using advanced medical equipment and technology. They may extend life significantly resulting in much suffering without benefits. Patients are being consulted in for this decision making. Although patients in the ICU are cared for by staff with advanced technology and technical expertise, the palliative
team also requires communication skills to coordinate care with patients, care providers and families. Providing information to the family concerning progress of the disease and changes in management and about alternate measures available may allay some anxiety and allow rational planning of short and longer term goals. This can reduce anxiety, loneliness, fear, and may help explore important needs at the end of life. Especially, the weighing of prolonging life or extending the dying process. Caring for comfort during the critically ill patient’s last days is
an important mission for the palliative care team. Guidelines must explore these needs as part of training of health care providers who will be responsible for end of life care of patients.