Palliative Care for Patients With Physical Disabilities

Betty R. Ferrell, PhD, RN

Disclosures

April 13, 2017

The Right Course of Action

Marilyn's history of disability will probably have an impact on her new diagnosis of advanced cancer. It would not be the right course of action to deny Marilyn treatment for her advanced cancer. People with disabilities deserve quality care for new illnesses and complications of their disabilities. And although Marilyn might well benefit from psychosocial support, as would any patient diagnosed with cancer, her history of disability does not mean that she is unable to make decisions.

Marilyn's care should include honest information, advance care planning, and a comprehensive history and psychosocial assessment to understand how she is coping with her disability and her new diagnosis.

The Effect of Disability on Palliative Care Needs

Major advances in healthcare have helped people survive serious illness and injuries to live long lives despite disabilities. Those living with disabilities are also at risk for common comorbid conditions associated with limitations in function or medical treatment.[1,2,3]

A recent study conducted by Mitchell and colleagues[4] evaluated how persons with disabilities viewed advance care planning. Interviews revealed important perspectives, including past experiences with the healthcare system that created mistrust and common biases about the quality of life of those living with disabilities.

Palliative care is a rapidly expanding field that has demonstrated benefit to individuals across many diseases. Palliative care is based on the patient's values and goals of care. The palliative care community can learn much from those living with disabilities. Likewise, palliative care has much to offer these patients.

Caring for Marilyn as she faces a new diagnosis of life-threatening disease will require an understanding of her illness experiences, as well as her values. The voices of disabled patients have expressed the need for relationship-based care and decision-making.

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