Page 6 - Wound Care at End of Life Content: A Guide for Hospice Professionals - DEMO

Goals of Care

GOALS OF CARE:
The goal of palliative care is symptom control that promotes comfort and quality of life by
addressing individual physical, psychological, social and spiritual needs. This same goal applies
to palliative wound care, when patients at end‐of‐life have wounds that may or may not heal.

“The skin is essentially a window into the health of the body”
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Sibbald, Krasner, Lutz: SCALE

Wounds are a symptom of advanced disease processes and co‐morbidities. Products designed
to heal acute wounds may not have the same effect on chronic, non‐healing wounds or in
patients with poor nutritional intake. However, a patient’s quality of life can be improved or at
least maintained by controlling symptoms, such as pain, exudate, infection, odor, and bleeding.
Patients and caregivers should be able to focus on activities that are important to them.
Wound care decisions must be made with patient goals in mind and will be influenced by the
location of care and disease progression, as well as other priorities of the patient and family.

“Comfort may be the overriding and acceptable goal, even though it may be in conflict with best
skin care practice”
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Sibbald, Krasner, Lutz: SCALE

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Goals of care may be developed relative to the likelihood of healing the wound.
 Wound is healable within the patient’s life expectancy
 Wound may be maintained without progression
 Wound is non‐healable or palliative care is desired

Treatment plans consistent with patient and family goals of care depend on: 1,2
 Accurate wound diagnosis
 Patient life expectancy and wishes
 Family member expectations and capabilities
 Institutional policies at the patient’s residential care facility

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