緩和ケアと医学

抽象的な

Role of Palliative Care for the Intensive Care Unit Nurse Practitioner

Danielle L Hardin and Elizabeth Gonzales

Abstract According to the United States Census Bureau projections for the elderly population will nearly double from estimated 43.1 million in 2012 to an estimated 83.7 million by 2050. Elderly patients admitted to the intensive care unit suffer higher short term mortality and long term disability. Medicare spending growth is also affected with increases in chronic illness and the aging, Americans dying in the hospital following intensive care unit admission each year will likely increase. Many elderly Americans spend the majority of their last few months in the intensive care unit, with only a few days enrolled in hospice before dying, despite survey results that consistently indicate patients would prefer to die at home. They want trust and confidence in their medical team. This includes trust that heroic measures will be avoided (e.g. life support) when there is no meaningful recovery. Despite these wishes, many patients suffer the agony of unnecessary painful interventions rather than allowing the individual to die with dignity. With many elderly Americans spending the majority of their last few months in the intensive care unit before dying it is important that nurse practitioners be trained in palliative care. Palliative care training can be done multiple ways. The emergence of online technology allows for interactive modules. Mandatory training and providing incentives such as contact hours or certifications are additional options. Once trained intensive care nurse practitioners can facilitate training others