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Chapter 34 : Neurologic Aspects of Palliative Care for HIV/AIDS

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Neurologic Aspects of Palliative Care for HIV/AIDS, Page 1 of 2

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Abstract:

This chapter attempts to address the palliative-care issues that currently affect patients with HIV/AIDS and neurologic disease in many developed countries that have moved into the chronic-disease phase of the epidemic. The spectrum of morbidity and mortality in patients with AIDS has changed dramatically in recent years, following the advent of highly active antiretroviral therapy (HAART) in the mid-1990s. The chapter discusses the issues and the importance of incorporating a palliative care approach with respect to specific HIV-related neurologic conditions and symptoms. The current environment requires not only individual clinicians' sensitivity and expertise in dealing with the chronic symptom syndromes but also the institutional and programmatic response of the care delivery system in order to meet the needs effectively. While the chapter focuses on the palliative and supportive management of patients with HIV/AIDS with chronic neurologic disabilities and symptoms, it is important also to focus on care needs at the end of life for patients who die either of AIDS-related causes, of incurable comorbidities, or of other etiologies. In closing, it must be mentioned that the stresses and cumulative burden of caring for patients with AIDS in this chronic disease phase of the epidemic are also different from what they were earlier, when patients did not survive as long and there was a shorter shared history with their caregivers than is now the case.

Citation: Selwyn P, Booss J. 2009. Neurologic Aspects of Palliative Care for HIV/AIDS, p 489-497. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch34
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Treatment of pain: the WHO analgesic ladder. The guidelines for pain management are as follows:

Citation: Selwyn P, Booss J. 2009. Neurologic Aspects of Palliative Care for HIV/AIDS, p 489-497. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch34
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Tables

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TABLE 1

Medications used for palliative treatment of common symptoms in HIV/AIDS

Citation: Selwyn P, Booss J. 2009. Neurologic Aspects of Palliative Care for HIV/AIDS, p 489-497. In Goodkin K, Shapshak P, Verma A (ed), The Spectrum of Neuro-AIDS Disorders. ASM Press, Washington, DC. doi: 10.1128/9781555815691.ch34

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