This Journal feature begins with a case vignette highlightinga common clinical problem. Evidence supporting various strategiesis then presented, followed by a review of formal guidelines,when they exist. The article ends with the authors' clinicalrecommendations.
An 85-year-old man with New York Heart Association class IVheart failure, hypertension, and moderate Alzheimer's diseaseis admitted to the hospital after a hip fracture. His postoperativecourse is complicated by pneumonia, delirium, and pressure ulcerson his heels and sacrum. He is losing weight and is unable toparticipate in rehabilitation because of his confusion. Thisis his fourth hospitalization . . . [Full Text of this Article]
The Clinical Problem
Strategies and Evidence
The Role of Palliative Care
Physician–Patient Communication
Assessment and Treatment of Symptoms
Psychosocial, Spiritual, and Bereavement Support
Coordination of Care
Areas of Uncertainty
Guidelines
Conclusions and Recommendations
Source Information
From the Hertzberg Palliative Care Institute, Brookdale Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York.
Address reprint requests to Dr. Morrison at the Department of Geriatrics, Box 1070, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, or at sean.morrison@mssm.edu.
Related Letters:
Palliative Care
Stovall E. L., Kane R. C., Morrison R. S., Meier D. E.
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N Engl J Med 2004;
351:1148-1149, Sep 9, 2004.
Correspondence
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