A Guide to Primary Care of People with HIV/AIDS - Canadian Public ...

A Guide to Primary Care of People with HIV/AIDS
Chapter 15: Palliative and End-of-Life Care
KEY POINTS
Palliative medicine is the discipline
devoted to the relief of suffering and the
promotion of quality of life. Palliative
care has often been thought to be limited
to end-of-life or hospice care; it is rather
a more general term for the type of
supportive care needed throughout the
trajectory of HIV disease.
Advance care planning is an attempt
to identify a decisionmaker should the
patient become unable to communicate
his or her own wishes.
Deciding when to make the transition
from curative/restorative mode to one of
comfort measures only and having the
skills to communicate this to the patient
are probably the greatest challenges
facing the provider.
There are multiple physical, psychosocial,
and spiritual issues that need resolution
in order for the patient to die peacefully
and to leave satisfactory memories for
family and friends.
The focus of providers tends to be on
caring for others. Providers who suffer
from the death of more than one patient
over a short time period can experience
symptoms of post-traumatic stress
disorder. They need to take the time to
effectively grieve.
SUGGESTED RESOURCES
Alexander C. Palliative and end-of-life
care. In Anderson J, ed. A Guide to the
Clinical Care of Women with HIV. Rockville,
MD: Health Resources and Services
Administration; 2001. Available at
http://www.hab.hrsa.gov.
Doyle D, Hanks GWC, Cherny N, and
Calman K, eds. The Oxford Textbook of
Palliative Medicine, 3rd ed. New York:
Oxford University Press; 2003.
O’Neill, JF, Selwyn, PA, and Schietinger, H,
eds. The Clinical Guide to Supportive and
Palliative Care for HIV/AIDS. Rockville,
MD: Health Resources and Services
Administration; 2002. Available at
http://www.hab.hrsa.gov.
Selwyn PA, Rivard M. Palliative care for
AIDS: Challenges and opportunities in the
era of highly active antiretroviral therapy.
J Palliat Med. 2003;6:475-487.
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U.S. Department of Health and Human Services, Health Resources and Services Administration, HIV/AIDS Bureau