Journal: Journal of palliative medicine
This article reviews best practices for managing wounds in patients with serious illness receiving palliative care or hospice. It emphasizes that wounds are highly prevalent and often complex in this population due to immobility, functional decline, malnutrition, advancing disease, and age-related skin changes.
The authors highlight that wounds can significantly increase suffering through pain, odor, exudate, functional impairment, and psychological distress. They argue that management should be driven by the patient’s prognosis and goals of care, prioritizing comfort and quality of life over curative intent.
Using input from palliative care clinicians, geriatricians, geropsychologists, and wound-care specialists, the article presents practical, principle-based guidance on:
- Integrating wound care into broader serious-illness management and advance care planning.
- Choosing care settings and interventions that are realistic and sustainable for patients and caregivers.
- Tailoring approaches to the underlying disease process, rather than applying one-size-fits-all treatment.
- Systematically addressing symptom clusters (pain, odor, drainage) and associated emotional and psychosocial distress.
The central message is that an interdisciplinary, goal-concordant, and symptom-focused strategy is essential to reduce both the physical and emotional burdens of wounds in palliative and hospice populations.