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Hematology 2008

Palliative Care and Psychosocial Contributions in the ICU

Matthew J. Loscalzo1

Correspondence: Matthew J. Loscalzo, MSW, Admin. Director of the Sheri & Les Biller Patient and Family Resource Center, City of Hope, 1500 East Duarte Road, Duarte, CA 91010; Phone: 626-930-5487; e-mail: mloscalzo{at}coh.org

Abstract

Psychosocial domains and palliative care medicine are the connective tissue of our fragmented health care system. The psychosocial domains of palliative care are central to creating new partnerships with physicians, patients, and their caregivers in emotionally charged medical environments, especially Intensive Care Units. Managing the psychological, social, emotional, spiritual, practical and existential reactions of patients and their loved ones supports effective action and problem-solving. Practical aspects to establishing realistic goals of care among the health care team and other specialists, communicating effectively with patients and families in crisis, using the diverse and ambiguous emotional responses of patients, families, faculty and staff therapeutically, and helping to create meaning in the experience is essential to whole-patient and family care centered. The family conference is an excellent vehicle to create an environment of honest and open communication focused on mobilizing the resources of the patient, family and health care team toward a mutually agreed upon plan of action resulting in clearly defined goals of care.


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Copyright © 2008 by the American Society of Hematology.