Palliative Wound Care

Karen Zulkowski's picture

By Karen Zulkowski DNS, RN, CWS

Last month I talked about the issues that occurred during my husband’s knee surgery. This month I want to bring the focus back to lawsuits and how they arise. What are the implications for the patient and family, and how does palliative wound care fit in?

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Aletha Tippett MD's picture

By Aletha Tippett MD

Palliative wound care is a relatively new field targeting wound treatment for patients at the end of life, or patients with terminal disease or inability to tolerate standard care. The traditional goal of wound care is to heal or prepare for surgical closure, but techniques and procedures used to “heal” a wound can be painful or uncomfortable and very costly, plus patients who qualify for palliative care may not live long enough to heal a wound.

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Mary Ellen Posthauer's picture

By Mary Ellen Posthauer RDN, CD, LD, FAND

Food is a major part of our lives with strong emotional and symbolic implications that encompasses nurturing, cultural, religion, tradition and social values. Nutrition and hydration has an effective role in healing wounds, but cannot prevent an individual with co-morbid conditions at the end of life from suffering or imminent death. This concept is often difficult to explain to the individual and especially to the caregivers who view nutrition and hydration as essential for life.

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Karen Zulkowski's picture

By Karen Zulkowski DNS, RN, CWS

As health care professionals we always want to heal our patients and make them better. This may not always be possible. We need to understand that not letting the pressure ulcer or wound we are treating get worse sometimes has to be the realistic goal.

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Aletha Tippett MD's picture
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By Aletha Tippett MD

For a physician or nurse in wound care, the primary thing to remember is this: you are not just seeing a wound, you are seeing a person who has a wound. Do not lose sight of this human and their humanity. Always look at the whole picture of your patient, not just their wound. Find out what is important to them and for them. Your patient might tell you, “Doc, I don’t care about the wound, I just can’t stand the smell,” or “Doc, just cut my leg off because I can’t stand the pain.”

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Aletha Tippett MD's picture
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By Aletha Tippett MD

What is palliative care relative to wound treatment? In short, it is about humanity, caring and compassion. Today I saw a 90 year-old woman in a nursing home. She had hip and ankle fractures, and developed a sacral ulcer in the hospital. She was in excruciating pain, screaming at every touch. To correct her turned-in hips, she was trussed up in a hip abductor device – she called this “the dragon” – that was both uncomfortable and painful.

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