A patient-centred interdisciplinary palliative care programme for end-stage chronic respiratory diseases

Palliative care should be part of integrated care for patients with end-stage respiratory diseases. An intensive inpatient interdisciplinary palliative care programme has been developed for patients with end-stage respiratory diseases in the Netherlands. This programme consists of the management of daily symptoms and care needs to support patients and their families, and maintain or improve quality of life of these patients and their loved ones. This article presents case studies which describe the clinical course and management of three patients admitted to the programme: a 77-year-old woman who died from chronic obstructive pulmonary disease (COPD); a 60-year-old woman with end-stage COPD who improved her daily functioning and was discharged home after 3 months; and a 74-year-old woman who died of pulmonary fibrosis. This article describes the characteristics of the programme and shows the possible benefits of an intensive patient-centred interdisciplinary palliative care programme for patients with end-stage respiratory diseases. Palliative care programmes can be the final step in the chain of care for patients with respiratory diseases. Further research is necessary to study whether, and to what extent, a patient-centred interdisciplinary palliative care programme for end-stage respiratory diseases may improve health status, daily symptom burden, patient satisfaction and quality of dying.