Understanding non-pharmacological palliative care for people with serious COPD: the individual and organizational perspective.

This narrative review emphasizes the growing interest in palliative care for people with serious lung diseases, such as COPD. It reflects upon recent publications from the American Thoracic Society (ATS), the World Health Organization (WHO) and European Respiratory Society (ERS) with a focus on non-pharmacological palliative care for people with COPD, from both the healthcare professional and the organizational perspective. The concept of palliative care has changed over time and is now seen as applicable throughout the whole disease trajectory according to need, in conjunction with any disease-modifying therapies. Palliative care should pay attention to the needs of the person with COPD as well as the informal caregiver. Timely integration of palliative care with disease-modifying treatment requires assessment of needs at the individual level as well as organizational changes. High-quality communication, including advance care planning is a cornerstone of palliative care. Therefore, services should be based on the understanding that palliative care is not just specific standardized actions and treatments, but a holistic approach that includes compassionate communication and treatment and care addressing the patient, informal and formal caregivers. Living with and dying from COPD is much more than objective measurements. It is the sum of relationships with others and the experience of living in the best possible harmony with one's own values and hopes despite having a serious illness.

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