Lindsey Jaclyn M, Shelton K Maureen, Beito Allison H, Lapid Maria I
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Lindsey, Shelton, Beito, Lapid).
Focus (Am Psychiatr Publ). 2021 Jul;19(3):311-319. doi: 10.1176/appi.focus.20210005. Epub 2021 Jul 9.
Psychiatrists can make a significant contribution to improving quality end-of-life care for psychiatric patients, beyond managing their psychiatric and psychological conditions. Geriatric psychiatrists can build expertise in enhancing end-of-life care when caring for older adults with serious illnesses and their families, given the biopsychosociospiritual approach that significantly overlaps with palliative and hospice care approaches. To effectively add quality to end-of-life care, it is essential for psychiatrists to understand the core principles and practices of palliative and hospice care, learn basic symptom management skills, and hone the ability to have crucial conversations regarding prognosis and advance care planning. Also important is recognizing when to refer to hospice and palliative medicine subspecialists. This article provides an overview of palliative and hospice care, uses a case study to illustrate components of palliative and hospice care relevant to geriatric psychiatry practice, and comments on considerations pertinent to the coronavirus disease 2019 (COVID-19) pandemic.
精神科医生除了管理精神疾病患者的精神和心理状况外,还可以为提高精神科患者的临终关怀质量做出重大贡献。鉴于老年精神科医生采用的生物心理社会精神方法与姑息治疗和临终关怀方法有很大重叠,在照顾患有严重疾病的老年人及其家人时,他们可以积累提高临终关怀的专业知识。为了有效地提高临终关怀质量,精神科医生必须了解姑息治疗和临终关怀的核心原则与实践,学习基本的症状管理技能,并磨练就预后和预先护理计划进行关键对话的能力。认识到何时转诊至临终关怀和姑息医学亚专科医生也很重要。本文概述了姑息治疗和临终关怀,通过一个案例研究来说明与老年精神病学实践相关的姑息治疗和临终关怀的组成部分,并对与2019冠状病毒病(COVID-19)大流行相关的注意事项发表评论。