Top Ten Tips Palliative Care Clinicians Should Know About Wound Care

Abstract

Wounds are a common and burdensome problem for patients with serious illness receiving palliative care and hospice services. Declining mobility, functional impairment, malnutrition, progression of underlying disease, and age-related skin changes all increase risk. Wound management can therefore be challenging for clinicians, patients, and caregivers. Symptoms such as pain, odor, drainage, functional limitations, and psychological distress can substantially worsen suffering. Optimal care requires an interdisciplinary approach that considers the patient’s underlying illness, prognosis, and goals of care. Palliative care clinicians are well-positioned to reduce this distress and improve comfort through goal-concordant wound-care strategies. Given the high prevalence of wounds in palliative care populations and the need for skilled, patient-centered management, we convened a panel of palliative care clinicians, geriatricians, geropsychologists, and wound-care specialists to identify core principles and practical strategies for supporting patients with wounds. In this article, we outline key tips for assessing and managing wounds, including understanding prognosis and goals of care, evaluating care settings, tailoring management to the underlying disease process, and addressing symptoms such as pain, odor, and psychosocial distress. A thoughtful, interdisciplinary approach is essential to reduce the physical and emotional burden wounds place on patients and caregivers.