HIV / AIDS Palliative Care Work Group Carla Alexander, MD And Tony Back, MD 2/2002.
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Transcript of HIV / AIDS Palliative Care Work Group Carla Alexander, MD And Tony Back, MD 2/2002.
HIV / AIDS Palliative Care Work Group
Carla Alexander, MDCarla Alexander, MD
AndAnd
Tony Back, MDTony Back, MD
2/20022/2002
Why now?
With longer life expectancy quality With longer life expectancy quality of life more importantof life more important
Decreasing mortality rate gives Decreasing mortality rate gives false sense of security (chronic false sense of security (chronic illness)illness)
Current providers not prepared to Current providers not prepared to cope with declinecope with decline
HIV as a chronic illness
Like CHF & COPD – Same Like CHF & COPD – Same medications throughout coursemedications throughout course
Course of therapy not necessarily Course of therapy not necessarily congruent with clinical responsecongruent with clinical response
More like cancer but when to d/c More like cancer but when to d/c drugs ?drugs ?
Changing epidemiology
PopulationsPopulations Dually and triply diagnosedDually and triply diagnosed PrisonsPrisons WomenWomen Younger generation & childrenYounger generation & children
Research
Epidemiology of symptoms & of dyingEpidemiology of symptoms & of dying Prognostic indicatorsPrognostic indicators Evaluate existing AIDS literature re Evaluate existing AIDS literature re
palliative issuespalliative issues Identify policy issuesIdentify policy issues Methods for motivating internal Methods for motivating internal
championschampions
Education
Clinician-directed & patient-directedClinician-directed & patient-directed Traditional topics, egTraditional topics, eg
Communications skillsCommunications skills Goal settingGoal setting
Personal awarenessPersonal awareness Teaching strategiesTeaching strategies Policy issuesPolicy issues
Clinical Care
Standards of careStandards of care What exists ?What exists ? Survey of how programs handle end of Survey of how programs handle end of
life issueslife issues Identify model systems for deliveryIdentify model systems for delivery
Social Dimensions
Advocacy / support / community / Advocacy / support / community / cultureculture
Define appropriate expectationsDefine appropriate expectations How to help professionals develop How to help professionals develop
sensitivitiessensitivities Uncover true costs of careUncover true costs of care
Not in the scope but of utmost importance . . .
International picture of epidemicInternational picture of epidemic Palliative care not to supplant Palliative care not to supplant
care but to offer support care but to offer support regardless of treatment optionsregardless of treatment options