Collins Erin F, Galloway-Salazar Qwynn, Johnson Elizabeth, Blechman Jennifer, Rush Merilynne, Clare Emma, Johnson Ashley, Sethi Aditi, Rosa William E, Izumi Seiko
The Peaceful Presence Project, Bend, Oregon, USA.
In Their Honor, Snellville, Georgia, USA.
J Palliat Med. 2025 Jun;28(6):808-814. doi: 10.1089/jpm.2024.0261. Epub 2024 Jul 29.
Palliative care has made great strides in improving the lives of people living with serious illness, with an empirical premise for increasing quality, and sometimes quantity of life. Yet in some cases, there exist gaps that impede the ability of palliative care clinicians to truly advocate, procure, and provide the comprehensive services needed for patients, family caregivers, and communities, particularly in the contexts of caring for marginalized populations and working in under-resourced practice settings. The end-of-life doula role has emerged over the last decade and the availability of trained doulas in the community has burgeoned. An end-of-life doula is a nonmedical, holistic support person who provides education, guidance, emotional, spiritual, and practical support to persons and families navigating serious and terminal illness, ideally early in the disease process, throughout the time surrounding death, and during bereavement. A pervasive Western culture of avoiding the subject of death means that we, as a society, often do not know or remember how to navigate the journey of end of life in a way that is caring, compassionate, skilled, holistic, and centered on the needs and worldview of the dying one. The ten tips provided here can guide palliative care clinicians to leverage collaboration with trusted, community-based end-of-life doulas to ensure comprehensive and people-centered palliative care.
姑息治疗在改善重症患者生活方面取得了巨大进展，其基于提高生活质量、有时也包括延长生命的实证前提。然而，在某些情况下，仍存在差距，阻碍了姑息治疗临床医生真正倡导、获取并提供患者、家庭照护者和社区所需的全面服务，特别是在照顾边缘化人群以及在资源匮乏的实践环境中工作时。临终关怀陪伴者的角色在过去十年中出现，社区中经过培训的陪伴者数量迅速增加。临终关怀陪伴者是一名非医疗的、提供全面支持的人员，为正在经历重症和绝症的个人及家庭提供教育、指导、情感、精神和实际支持，理想情况是在疾病过程早期、围绕死亡的整个期间以及丧亲期间提供支持。西方普遍存在的回避死亡话题的文化意味着，作为一个社会，我们常常不知道或不记得如何以关怀、富有同情心、熟练、全面且以垂死者的需求和世界观为中心的方式走过生命的终点之旅。这里提供的十条建议可以指导姑息治疗临床医生利用与值得信赖的、基于社区的临终关怀陪伴者的合作，以确保提供全面且以人为本的姑息治疗。
