Betty R. Ferrell, PhD, RN

Disclosures

May 10, 2016

Palliative Care for Patients With Post-traumatic Stress Disorder (PTSD)

PTSD occurs when life-threatening events, including national disasters, childhood traumas, or other events create long-lasting effects.[1,2,3] PTSD affects coping with future life events, including illnesses. Clinicians caring for patients with serious illness often learn of traumatic events in the course of assessment or when this trauma affects the patient's symptoms or ability to cope with a terminal diagnosis.[4,5,6] Many veterans experience PTSD, and their wartime memories that have not been shared for many years may emerge as a critical influence in their care.

Palliative care can be very helpful in providing an interdisciplinary team of physicians, nurses, social workers, and chaplains to address PTSD. In some instances, the palliative care team may need to consult with psychiatric care providers, because some patients will require expert counseling or have other psychiatric comorbid conditions.

As with other untreated psychiatric illnesses, failure to assess and respond to PTSD can compromise patient care and, as in the case above, influence treatment compliance, symptoms, and coping. Excellent care for seriously ill patients with PTSD can move them from despair and helplessness to a sense of coping or even resilience as they face the current illness.[1]

In Aretha's case, there are many indications for palliative care, including psychological support for her current illness and control of symptoms. Palliative care is best implemented early in the course of disease, especially in patients like Aretha with complex needs. The effects of PTSD are long lasting and must be supported rather than minimized. The best care for Aretha is that which incorporates excellent palliative care with attention to the experience of PTSD.

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