Cognitive assessments – What do they add to palliative care? A case study

Aim:
Patients with brain tumours often pose interesting challenges for the palliative care team. How do we palliate symptoms such as psychosis and loss of occupational functioning? In this case study we look at the usefulness of a neuropsychological test which was developed to assess deficits in brain functioning in brain injured patients at a time when radiation technology was in its infancy (1941). This case study looks at neuropsychological assessment and its contribution to the palliation of a 38 year old male with a diagnosis of Oligodendroglioma.

Method:
We discuss the apparent unremarkable differences in repeated CT scans of the brain over four months with the first at diagnosis and the second prior to admission to the palliative care service. Next we undertake the clinical assessment of functional decline utilizing psychiatric interview, mini mental state examination and the Rey-Osterrieth Complex Figure Test.

Findings:
In this case we found that neuropsychological testing added valuable information to the formulation of the palliative care needs of this patient. In our service we now apply routinely neuropsychological assessment to aid in the palliation of those patients with advanced disease and brain involvement.