Ask the treatment expert ... about palliative wound care
Rosalyn Jordan, RN, BSN, MSc, CWOCN, WCC
Palliative care is focused on the relief of symptoms with a goal to improve the quality of the individual's life.
Wounds often are associated with symptoms that require attention in order to improve the quality of life. Wounds can be painful, produce odors that are embarrassing to the resident, and lead to infection that is dangerous not only to the resident but also to caregivers and family members.
Attention to these wounds is imperative to attain the goals of quality of life, focused on pain relief and dignity.
Holistic assessments are essential. Wound assessment includes the resident's diagnosis and the life expectancy. The type of wound is important information to include along with the clinical appearance.
The major difference in wound care for a resident receiving palliative care is how often to measure wounds. According to the NPUAP, since wounds are routinely measured to assess healing, and healing is seldom an outcome or goal for persons that have chosen to receive palliative, end-of-life care, there is no purpose for frequent wound measurements.
Based on the resident's condition, include documentation related to the resident's response when the wound is measured. Include specific wound measurement intervals in the plan of care. If the measuring procedure introduces a painful experience or if the resident is near the end of life, noting this in the medical record and foregoing the wound measurement wound allow comfort and quality time.
The absolute goals of palliative wound care include: stabilization of existing wound, prevention of new wounds, maximization of quality of life, and provision of the best treatment for the resident