Palliative care affirms the value of holistic support for persons facing death from advanced disease. Increasingly the approach of palliative care is seen as relevant not only to terminal cancer (its initial concern) but also to many other incurable conditions. To date, the major emphasis of specialist neurology has been on diagnosis, and the continuing long term management of the many major diseases has received far less attention. This handbook aims to provide succinct and practical advice on the management of major neurological disorders in both their supportive and terminal phases, recognizing that these conditions are increasing in prevalence in virtually every society as the proportion of elderly persons grows. It demonstrates how the discomforts encountered in dementia, stroke, Parkinson's disease, ALS, Huntington's disease, muscular dystrophies and multiple sclerosis can benefit from the same comprehensive approach to palliation as has evolved in specialist care for cancer.
Indice testuale
Part I. Palliative Management: 1. Introduction to palliation; 2. Characteristics of palliation; 3. Nodal points in decision-making for neurological diseases; 4. Potential deficiencies in palliative management in neurology; 5. Common themes in palliation practice; Part II. 1. Fatigue: 2. Problems with muscles and movement; 3. Bulbar symptoms; 4. Respiratory symptoms; 5. Gastro-intestinal symptoms; 6. Urological symptoms; 7. Pain; 8. Cognitive, behavioural and psychological symptoms; 9. Miscellaneous symptoms; Part III. Major Neurological Conditions Requiring Palliation: 1. Cerebrovascular diseases and stroke; 2. Demyelinating diseases (MS); 3. Parkinson's disease and related disorders; 4. Dementia; 5. ALS (motor neurone disease); 6. Viral and prion infections - rabies, HIV, CJD; 7. Muscular dystrophies; 8. Neuropathy; 9. Huntington's disease; 10. Cerebral neoplasms; 11. Sequelae of traumatic brain injury and spinal injury; Part IV. Ethical Issues: 1. Consent and decision-making; 2. Advance directives; 3. Proxy decision-making; 4. Ethical issues in states of altered consciousness; 5. Terminal sedation; 6. Euthanasia; Part V. Appendices: 1. Practical aspects of home care; 2. The criteria for an effective palliation service; 3. Suggested further reading; 4. Medications referred to in the text.
