Wound Care at the End-of-Life

Treating wounds in any patient population can be quite challenging.  There are multiple factors required to heal a wound including topical, systemic and environmental interventions that must be carefully chosen to meet each individual patients needs. There is a multitude of medical technology to promote healing in all types of wounds, some with extensive patient participation and expensive price tags.   But what happens when the patient is approaching the end-of-life?  Is it reasonable to change the course of wound care from healing to palliative care?  Indeed, a difficult decision but one that can only be made by the patient and their family.  Palliative wound care changes the goal of wound care from healing the wound to treating the symptoms of the wound. 

Symptom management is the goal of palliative wound care.  Pain control is always a priority.  Odor, exudate and bleeding issues dictate the type of treatment to be used for the wound.  The decision to shift to palliative wound care may be somewhat unsettling for caregivers and patients making emotional support part of the treatment plan as well. There are multiple treatment options that manage wound symptoms; exudate, odor, and bleeding while decreasing the frequency of dressing changes and promoting patient comfort.

Palliative wound care does not diminish the commitment to patient care. It allows for medically appropriate wound care using a compassionate, gentle approach realizing that wound healing is no longer a reasonable goal for the patient.