Table 2.

Primary palliative care skills for the stroke specialist

	Primary Stroke Palliative Care Skills
Pain and Symptoms	Recognize early signs of pain, depression, anxiety, delirium Basic symptom management skills
Communication skills	Communicate with empathy and compassion Authentic and active listening Narrative competence to elicit the patient's story Effectively elicit individual treatment goals (see “Goals of care”) Effectively share information with the patient and family using terms they understand Communicate prognosis for quantity and quality of life Provide anticipatory guidance regarding illness and treatment trajectories Develop consensus for difficult decisions in a way that is sensitive to the patient's/family's preferred role of decision-making Identify and manage moral distress among interdisciplinary team members
Psychosocial and spiritual support	Identify psychosocial and emotional needs of patients and families Identify needs for spiritual or religious support and provide referral Access resources that can help meet psychosocial needs Practice cultural humility
Goals of care	Help family establish goals of care based on patient and family values, goals, and treatment preferences Willing and able to engage in shared decision-making and adapt shared decision-making approach to patient and family preferences Incorporate ethical principles in communication and decision-making
End-of-Life Care	Emphasize non-abandonment and provide continued emotional support through the dying process for patients and their families Provide anticipatory guidance regarding the dying process for patients and their families Facilitate bereavement support for family members