8/14/2019 Orzi Francesco

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Pain and other symptoms

Palliative care for cancer patients

Palliative care for non cancer

patients

Paediatric palliative care

Palliative care for the elderly

The actors of palliative care

Latest on drugs

Pain

Illness and suffering through

media

Marginalisation and social stigma

at the end of life

Palliative care advocacy projects

Prognosis and diagnosis

communication in

different cultures

Communication between doctor-

patient and patient-

equipe

Religions and cultures versus

suffering, death and

bereavement

Public institution in the world:

palliative care policies

and law

Palliative care: from villages to metropolies

Space, light and gardens for the terminally ill patient

End-of-life ethics

Complementary therapies

Education, training and research

Fund-raising and no-profit

Bereavement support

Volunteering in palliative care

Rehabilitation in palliative care

Palliative care and evidence based medicine in Neurology

Authors (max 6, presenting author included): Francesco Orzi

Palliative interventions in neurology are being covered by an emerging field,which bridges neurology and palliative medicine into a new subspecialty.Neurologic diseases may differ from the traditional diseases cared for bypalliative care physicians because of the often long progressive course, incontrast to the relentless progression seen in many cancers. Given theseobstinate features, prognostication is much more difficult in neurology andprolonged periods of accumulating disability much more common. Manydisease that clearly have palliative care needs, have been given relativelylittle attention in the palliative care. These include muscular dystrophies,Huntington disease, sequela of brain injury, and stroke, amyotrophic lateral

sclerosis, cerebral neoplasms, HIV infection, and multiple sclerosis, anddementia. A person with dementia, for instance, challenges the neurologistwith problems and needs traditionally not covered in academic trainings. Thecare of people with severe dementia largely involves compensating for theirdiminishing ability to fulfill basic needs by providing assistance in areas suchas activities of daily living, mobility, safety and function, toileting, mouthcare, and grooming. The prevention, management, or elimination ofdiscomfort such as pain, constipation, skin deterioration, malnutrition,physical exhaustion, and adverse drug reactions are also areas that arecentral to the provision of basic physical care. A person-oriented attitude,however, can come at the expense of a task oriented, objective and guidedapproach that is central to the evidence-based medicine.

Thus, while palliative approaches appropriately include phenomenological

perspectives, and stress the care for the person more than for the disease, amain question remains about how to measure and explore clinical outcomesof neurological palliative care. Answering such a question would be functionalto maintain both the benefit of a person-centered care and the quality of thescientific evidence.

Session: Rehabilitation in palliative care

Chair of the session: Claudio Pellegrini

Antea Worldwide Palliative Care ConferenceRome, 12-14 November 2008

Francesco Orzi

francesco.orzi@uniroma1.it

mailto:francesco.orzi@uniroma1.itmailto:francesco.orzi@uniroma1.it