RT Journal Article SR Electronic T1 Integration of Palliative Care in Chronic Critical Illness Management JF Respiratory Care FD American Association for Respiratory Care SP 1004 OP 1013 DO 10.4187/respcare.01624 VO 57 IS 6 A1 Judith E Nelson A1 Aluko A Hope YR 2012 UL http://rc.rcjournal.com/content/57/6/1004.abstract AB Palliative care is an essential component of comprehensive care for all patients with chronic critical illness, including those receiving restorative or life-sustaining therapies. Core elements include alleviation of symptom distress, communication about care goals, alignment of treatment with the patient's values and preferences, transitional planning, and family support. Here we address strategies for assessment and management of symptoms, including pain, dyspnea, and depression, and for assisting patients to communicate while endotracheally intubated. We also discuss approaches to optimize communication among clinicians, patients, and families about care goals. Challenges for supporting families and planning for transitions between care settings are identified, while the value of interdisciplinary input is emphasized. We review “consultative” and “integrative” models for integrating palliative care and restorative critical care. Finally, we highlight key ethical issues that arise in the care of chronically critically ill patients and their families.