Palliative Care & Oncology
The care of patients at the end-of-life is transforming rapidly in the United States. Fewer patients are dying in the hospital, more patients access palliative care services through hospice programs and inpatient consultative services, and there is a greater awareness of palliative care among physicians and the lay public. Improvements in end-of-life care are particularly timely right now as the United States faces a doubling of individuals above the age of 65 over the next several decades.
Life-threatening and life-limiting illnesses are highly comorbid with psychiatric disorders. Such disorders include both de novo disorders arising in the setting of advanced medical illness and exacerbations of underlying mental illness. They range from sub-syndromal depression and anxiety, to delirium and psychotic disorders. Additionally, the mental health needs of individuals with serious medical illness transcend the paradigm of traditional psychopathology and include aspects of psychosocial care such as optimization of social support, supporting individuals in recognizing and meeting age appropriate developmental goals at the end-of-life, navigating existential concerns, and addressing caregiver and bereavement support.
The field of palliative psychiatry has emerged in response to these needs and has developed into an integral part of end-of-life care. As the field of palliative psychiatry evolves, an understanding of the nuances of care across populations will be important for effective clinical practice. The care of such populations, including children and adolescents, widowed parents, and individuals with serious mental illness, requires distinct clinical skills and knowledge. This symposium brings together several speakers to discuss psychiatric end-of-life care across diverse populations with a focus on the increasing sub-specialized skills that consultation-liaison psychiatrists will require in the rapidly evolving landscape of end-of-life care.
Dr. Daniel Shalev will introduce the topic and provide a discussion on “palliative psychiatry in the absence of psychopathology” with a focus on the concept of the “good death” and the role of psychiatrists in formulating and promoting developmental milestones at the end-of-life. (15 minutes)
Dr. Annah Abrams will address challenges around hearing and honoring end-of-life goals and wishes in children and adolescents. (15 minutes)
Dr. Kelly Irwin will discuss the role of psychiatrists in end-of-life care for patients with serious mental illness. (15 minutes)
Dr. Jon Levenson will discuss special considerations for psychiatric end-of-life care in the oncology population. (15 minutes)
Dr. Donald Rosenstein will discuss bereavement care with a particular focus on widowed parents. (15 minutes)
There will be 15 minutes allotted for questions and discussion at the conclusion of the session.