‘Trauma cues’ help clinicians identify re-living trauma near death: a discussion paper

Résumé fourni par la source

Re-living trauma near death is a recognised phenomenon that is associated with increased pain and suffering. It presents with additional physical and psychological symptoms that can be ameliorated with improved clinical knowledge and appropriate management. Dying cancer patients living in developed countries have increasingly benefited from access to quality, effective palliative care, but this is not the case for other populations, where inequity and inequality of access to palliative care exist. Access to palliative care is dependent on where people live, there diagnosis, age, and circumstances of deprivation. Circumstances of deprivation may include people dying from dementia, in poverty, experiencing homelessness, and/or long-term substance use. As these experiences are more frequently observed in trauma survivors, people with a trauma history may experience dying with poor access to palliative care, increased suffering and unmet needs. This paper aims to explore and discuss the importance of identifying re-living trauma near death and offers an evidence-based approach for clinicians to do so using ‘trauma cues’. Trauma cues are presentations of symptoms that may occur in trauma survivors in the last weeks of their life, regardless of whether a history of trauma has been disclosed/documented. Trauma cues may be utilised to improve clinicians’ ability to identify re-living trauma near death for people dying, with or without cognitive impairment. The clinical practice of a Palliative Care Nurse Practitioner will be presented using composite case material to highlight trauma cues analysed against existing literature on re-living trauma near death.

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