Prolonged Critical Illness and Demoralization: Curative Factors in Hospice Care in the Age of COVID-19.
Identifieur interne : 000113 ( Main/Corpus ); précédent : 000112; suivant : 000114Prolonged Critical Illness and Demoralization: Curative Factors in Hospice Care in the Age of COVID-19.
Auteurs : Susan Delisle ; Frances Eichholz Heller ; Craig D. BlindermanSource :
- Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association [ 1539-0705 ] ; 2020.
English descriptors
- KwdEn :
- Aged (MeSH), Betacoronavirus (MeSH), COVID-19 (MeSH), Coronavirus Infections (epidemiology), Critical Illness (nursing), Critical Illness (psychology), Demoralization (MeSH), Hospice Care (MeSH), Humans (MeSH), Male (MeSH), Pandemics (MeSH), Pneumonia, Viral (epidemiology), Respiration, Artificial (MeSH), SARS-CoV-2 (MeSH), Terminal Care (MeSH).
- MESH :
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- nursing : Critical Illness.
- psychology : Critical Illness.
- Aged, Betacoronavirus, COVID-19, Demoralization, Hospice Care, Humans, Male, Pandemics, Respiration, Artificial, SARS-CoV-2, Terminal Care.
Abstract
In this case report, an elderly patient with COVID-19 pneumonia and a protracted intensive care course, who was unable to wean from mechanical ventilation, was transferred to the hospice unit for ventilator withdrawal and end of life care. Although symptom management was anticipated to focus on treating acute dyspnea, conditions mandated a shift to addressing the psychological challenges associated with prolonged critical illness. The interventions typical to hospice care-patient centered, family focused, and culturally sensitive-served to alleviate psychological symptoms of demoralization and despair, contributing to an outcome that pointed beyond pulmonary pathophysiology. Thought to be facing imminent death once the ventilator was removed, this patient defied the science behind weaning protocols, which can only be explained by a "will to live," through loving engagement with his family, his favorite music, and a dedicated multidisciplinary hospice team.
DOI: 10.1097/NJH.0000000000000689
PubMed: 32925491
Links to Exploration step
pubmed:32925491Le document en format XML
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<affiliation><nlm:affiliation>Susan Delisle, DNP, ANP-BC, PMHNP-BC, ACHPN, is nurse practitioner, Adult Palliative Care Service, Department of Medicine, Columbia University Medical Center, New York, New York. Frances Eichholz Heller, LMSW, ACHP-SW, is senior social worker, Adult Palliative Care Consult Service, NY Presbyterian, Columbia University Medical Center. Craig D. Blinderman, MD, MA, FAAHPM, is director, Adult Palliative Care Service, and associate professor, Department of Medicine, Columbia University Medical Center, New York, New York.</nlm:affiliation>
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<author><name sortKey="Heller, Frances Eichholz" sort="Heller, Frances Eichholz" uniqKey="Heller F" first="Frances Eichholz" last="Heller">Frances Eichholz Heller</name>
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<author><name sortKey="Blinderman, Craig D" sort="Blinderman, Craig D" uniqKey="Blinderman C" first="Craig D" last="Blinderman">Craig D. Blinderman</name>
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<affiliation><nlm:affiliation>Susan Delisle, DNP, ANP-BC, PMHNP-BC, ACHPN, is nurse practitioner, Adult Palliative Care Service, Department of Medicine, Columbia University Medical Center, New York, New York. Frances Eichholz Heller, LMSW, ACHP-SW, is senior social worker, Adult Palliative Care Consult Service, NY Presbyterian, Columbia University Medical Center. Craig D. Blinderman, MD, MA, FAAHPM, is director, Adult Palliative Care Service, and associate professor, Department of Medicine, Columbia University Medical Center, New York, New York.</nlm:affiliation>
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<term>Betacoronavirus (MeSH)</term>
<term>COVID-19 (MeSH)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>Critical Illness (nursing)</term>
<term>Critical Illness (psychology)</term>
<term>Demoralization (MeSH)</term>
<term>Hospice Care (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (epidemiology)</term>
<term>Respiration, Artificial (MeSH)</term>
<term>SARS-CoV-2 (MeSH)</term>
<term>Terminal Care (MeSH)</term>
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<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
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<term>COVID-19</term>
<term>Demoralization</term>
<term>Hospice Care</term>
<term>Humans</term>
<term>Male</term>
<term>Pandemics</term>
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<front><div type="abstract" xml:lang="en">In this case report, an elderly patient with COVID-19 pneumonia and a protracted intensive care course, who was unable to wean from mechanical ventilation, was transferred to the hospice unit for ventilator withdrawal and end of life care. Although symptom management was anticipated to focus on treating acute dyspnea, conditions mandated a shift to addressing the psychological challenges associated with prolonged critical illness. The interventions typical to hospice care-patient centered, family focused, and culturally sensitive-served to alleviate psychological symptoms of demoralization and despair, contributing to an outcome that pointed beyond pulmonary pathophysiology. Thought to be facing imminent death once the ventilator was removed, this patient defied the science behind weaning protocols, which can only be explained by a "will to live," through loving engagement with his family, his favorite music, and a dedicated multidisciplinary hospice team.</div>
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<Title>Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association</Title>
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<ArticleTitle>Prolonged Critical Illness and Demoralization: Curative Factors in Hospice Care in the Age of COVID-19.</ArticleTitle>
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<Abstract><AbstractText>In this case report, an elderly patient with COVID-19 pneumonia and a protracted intensive care course, who was unable to wean from mechanical ventilation, was transferred to the hospice unit for ventilator withdrawal and end of life care. Although symptom management was anticipated to focus on treating acute dyspnea, conditions mandated a shift to addressing the psychological challenges associated with prolonged critical illness. The interventions typical to hospice care-patient centered, family focused, and culturally sensitive-served to alleviate psychological symptoms of demoralization and despair, contributing to an outcome that pointed beyond pulmonary pathophysiology. Thought to be facing imminent death once the ventilator was removed, this patient defied the science behind weaning protocols, which can only be explained by a "will to live," through loving engagement with his family, his favorite music, and a dedicated multidisciplinary hospice team.</AbstractText>
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<AffiliationInfo><Affiliation>Susan Delisle, DNP, ANP-BC, PMHNP-BC, ACHPN, is nurse practitioner, Adult Palliative Care Service, Department of Medicine, Columbia University Medical Center, New York, New York. Frances Eichholz Heller, LMSW, ACHP-SW, is senior social worker, Adult Palliative Care Consult Service, NY Presbyterian, Columbia University Medical Center. Craig D. Blinderman, MD, MA, FAAHPM, is director, Adult Palliative Care Service, and associate professor, Department of Medicine, Columbia University Medical Center, New York, New York.</Affiliation>
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