Article Title: Pressure Injury Progression and Factors Associated With Different End-Points in a Home Palliative Care Setting: A Retrospective Chart Review Study
Authors: Artico M, D’Angelo D, Piredda M, et al
Journal: J Pain Symptom...
By Aletha Tippett MD
- How old is the individual?
- What is their primary diagnosis and how does it relate to their wound(s)?
- Does the individual have a strong support system of family/caregivers?
- What would they and their family like to have happen in regard to their care?
- Are they in hospice?
These questions need to be answered to guide you in taking any further actions in their care. First and foremost, the goal is to take care of the individual in a way that they will allow. Maybe you have been called to see an individual with a wound, but pain is their main problem, and they long to be out of pain. The objective should be to address the individual’s pain first, and then approach the treatment of the wound once the pain has been managed. Or perhaps the individual has a wound, but their main concern is with its odor. Their request may be to just control the odor so they can be with their family.
Assess the Wound
If, in your preliminary assessment, the wound is something that needs to be addressed, then determine what kind of wound it is and how it developed:
- What is the wound type?
- What is the location of the wound?
- Has the etiology and related risk factors of the wound been determined and addressed?
- How long has the wound been present?
- Is the wound painful?
These are just a few of the questions that will require investigation to determine what strategies you could use in approaching the management of the wound.
Once you know what type of wound you are working with, go back to your patient and ask the following questions to define the scope of care you are to provide:
- What are the goals of the individual?
- How long do they have to live?
- What interventions will they allow?
- Are the goals of the individual supported by their family/caregivers?
If the individual is near the end of their life and/or has terminal illness, or they are tired and don’t want further curative efforts, then they qualify for palliative treatment. Remember, the goals in palliative wound care are to reduce pain, prevent infection, control odor, and improve quality of life for the individual. Any treatment program must be consistent with these goals. Answering these questions, discussing goals with the patient and their family and approaching their care with these responses in mind will help you determine the best approach in managing their wound condition.
Learning how to assess the palliative wound patient, then how to approach care will be topics of the Fourth Annual Palliative Wound Care Conference, May 16-18, 2013, in Indianapolis, Indiana. Visit HopeofHealing.org for more information on how to register.
About The Author
Aletha Tippett MD is a family medicine and wound care expert, founder and president of the Hope of Healing Foundation®, family physician, and international speaker on wound care.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.