Palliative Care and End-of-Life Care Planning after Critical Illness

Abstract

Palliative care is an interprofessional specialty and an approach to care that focuses on improving the quality of life of patients and their families who are facing serious illness. Palliative care can address many domains of symptoms and needs that are important to patients and families of critically ill patients including symptom assessment and management, communication to establish goals of care, alignment of treatments with patient preferences, attention to psychosocial and spiritual needs of both patients and their families, and planning for care transitions. Given these goals, palliative care principles and services can potentially benefit not only patients who are critically ill but also those who survive critical illness as many patients and families have palliative care needs that extend for months or years after critical illness. Older adults, people with fraility, and those with chronic critical illness might benefit most from palliative care services after critical illness. Several opportunities exist to integrate palliative care into post-ICU recovery either through integration into post-ICU clinics or in the delivery of community-based palliative care services, including enhancing communication to establish goals of care, aligning treatment plans with patient preferences for future medical care, supporting families, and helping plan and coordinate care transitions, and encouraging advance care planning.