Palliative care for chronic neurological disorders: A case series and literature review

Background: There has been increased interest in palliative care for Individuals with chronic neurological disorders, yet there are no specific case reports or illustrations on detailed palliative care practices. Palliative care services for neurological disorders in India are limited. Aim: To illustrate the generalist palliative care practice for persons with chronic neurological disorders in a tertiary care hospital. Materials and Methods: A case study design was used to demonstrate generalist palliative care in neurological disorders using five case studies. CARE guidelines used for reporting case studies. Results: Degenerative neurological conditions such as dementia, motor neuron diseases, Parkinson's disease, multiple sclerosis, Duchenne muscular dystrophy and other conditions such as progressive supranuclear palsy, sub-acute sclerosing pan encephalitis, mitochondrial disease, multiple system atrophy, stroke with poor prognosis need immense palliative care. Early identification of palliative care needs from the beginning of diagnosis, and the barriers in facilitating palliative care in tertiary care settings were discussed. The psychiatric social workers provided generalist palliative care such as communicating prognosis, addressing caregiver burden, end-of-life care issues, advance care planning, and appropriate referral to hospice care and other palliative care services. Conclusion: Palliative care for chronic neurological disorders is in its infant stage in India. There is limited awareness about the need for palliative care for chronic neurological disorders among social work trainees, neurology trainees, and other health care providers. Hence, there is a strong need to increase awareness and access to palliative care for persons with life limiting or life threatening chronic neurological disorders. It is feasible to provide generalist palliative care for chronic neurological disorders in a tertiary care setting.Keywords: Palliative care, neurological disorders, psychiatric social work interventions, end-of-life care