为退伍军人群体量身定制安宁疗护。

Curtis G Kommer, Autumn Nadolny
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引用次数: 0

摘要

美国退伍军人是越来越多的老年人群,越来越多的退伍军人在生命末期选择安宁疗护。这些退伍军人,尤其是参加过战斗的退伍军人,会给安宁疗护团队带来独特的管理挑战和机遇。本综述强调了许多退伍军人所经历的身体和社会心理创伤,并讨论了这些问题会如何影响他们的安宁疗护。与创伤相关的问题,如慢性疼痛、神经性疼痛、失眠和慢性头痛等,会在退伍军人的生命末期加剧,而这些创伤事件的心理后遗症,如创伤后应激障碍(PTSD)、慢性焦虑、药物滥用和自杀风险增加等,也会在这一时期放大。本综述详细介绍了这些以及其他常见的与服役相关的合并症,并就其诊断和治疗提出了循证建议。此外,它还讨论了生命末期对退伍军人的重要性,并就安宁疗护项目如何对这一特殊群体进行个性化和优化护理提出了建议。向退伍军人的服务致敬并尊重他们的牺牲也是临终关怀中 "最佳关怀 "的重要方面,本综述就如何做到这一点提出了建议,并列出了一份资源清单,这些资源可以极大地帮助安宁疗护项目、退伍军人和家属提供最尊重、最全面、最周到的关怀。
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Tailoring Hospice Care to the Veteran Population.

United States Military Veterans are an increasingly elderly population, and more and more veterans are choosing hospice care at the end of life. These veterans, particularly if they served in combat, can bring unique management challenges and opportunities to a hospice team. This review highlights the physical and psychosocial traumas experienced by many veterans, and discusses how these issues can affect their hospice care. Traumatic injury-related issues such as chronic pain, neuropathic pain, insomnia, and chronic headaches can worsen for veterans at the end of life, and the psychological sequelae of these traumatic events such as Post-Traumatic Stress Disorder (PTSD), Chronic Anxiety, Substance Abuse, and increased risk of suicide can also be magnified during this time. This review details these and other commonly seen service-related comorbidities, and offers evidence-based recommendations regarding their diagnosis and treatment. In addition, it discusses what is important to veterans at the end of life, and provides suggestions on how hospice programs can individualize and optimize their care of this special population. Honoring their service and respecting their sacrifices are also important aspects of "Best Care" for veterans at the end of life, and this review provides suggestions on how to do so and includes a list of resources that can greatly assist hospice programs, veterans, and families in delivering the most respectful, comprehensive, and thoughtful care possible.

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