Although all clinicians providing palliative care should address physical, social, financial and spiritual concerns, a triage system is needed to allocate clinicians for the provision of both primary and specialist-level palliative care.
Clinicians who are not palliative care specialists provide the following:
• identification and management of pain, dyspnea, agitated delirium and respiratory congestion;
• management of caregiver grief; and
• discussions about prognosis, goals of treatment, suffering, and resuscitation status.
Palliative care specialist clinicians treat:
• patients with complex or refractory symptoms;
• patients who are denied access to critical care owing to a triage protocol, despite wanting aggressive care;
• patients with young children; and
• patients belonging to marginalized populations, including the homeless, incarcerated persons, etc., who are at risk of being underserved by the health care system.
Palliative care specialist clinicians provide the following:
• management of complex depression, anxiety, grief, and existential distress;
• palliative sedation therapy; and
• treatment of preexisting opioid use disorder.
See reference for more information
Adapted from Arya A et al. Pandemic Palliative Care: Beyond ventilators and saving lives. CMAJ 2020. doi: 10.1503/cmaj.200465; early-released March 31, 2020. Internet. Available at https://www.cmaj.ca/content/192/15/E400.full Accessed on May 4, 2020.