Palliative care and end stage care for amyotrophic lateral sclerosis

Upload time:2016-10-25 Browse:

Author: Professor Li Xiaoguang
This article reprinted from the WeChat public number: nerve Xiaoguang, Neuroxgli. Copyright belongs to the original author, please indicate the source.
In the diagnosis of amyotrophic lateral sclerosis at the beginning of the treatment planning with patients and caregivers when they should be included in the palliative care program.
Palliative care aims to maximize the quality of life of patients and their families, to alleviate the symptoms, provide emotional and psychological needs and spiritual support to patients without pain leave, reduce family bereavement. Hospice care requires the participation of a community or hospice care institution, with the completion of a multidisciplinary collaborative care based on neurology clinic.
Recommendation:
1, in the early course of the disease, should be as far as possible to have palliative care team to provide support information.
2. When the patient is asked, he or she will begin to discuss the final decision, or provide an opportunity to discuss the relevant information and / or interventions at the end of the day.
3, to discuss the choice of respiratory support, decide when patients have difficulty breathing, other symptoms of low respiratory capacity or less than 50%, how to treat the choice.
4, to inform patients about the legal matters of prior wills. To provide help for the development of the final testament.
5, every 6 months to discuss the tendency of patients to maintain life therapy.
6, before the end of the ALS, as soon as possible to start the hospice care team support and the establishment of ex ante will.
7, to recognize the importance of the quality of life and treatment of mental factors.
8, for the difficulty of breathing and / or intractable pain symptomatic treatment, if there is anxiety can be given benzene two nitrogen, alone or in combination with opioids. Fine adjustment of drug dosage to improve clinical symptoms, rarely due to respiratory inhibition and life-threatening.
9, for the cause of high blood pressure caused by the death of the former and delirium, can use antipsychotic drugs (such as chlorpromazine 12.5 mg every 4-12 hours of oral, intravenous injection) treatment.
10, only when the symptoms of hypoxia, oxygen use symptomatic treatment.