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Palliative wound, ostomy, and continence care is a nascent area of palliative care nursing, with little research and few evidence-based guidelines to guide practice. The majority of patients at end of life will suffer from a wound, ostomy, or continence malady, requiring specialist-level consultation with a wound, ostomy, and continence nurse (WOC nurse). Palliative wound, ostomy, and continence care emphasizes an interprofessional, patient-centered approach to alleviate suffering and promote well-being and quality of life through the preservation or restoration of functional performance. A combination of evidence-based wound, ostomy, and continence nursing interventions and advanced symptom management science is the hallmark of this nursing specialty.

Timely, holistic interventions aimed at easing the despair of patients with advanced cancer and malignant fungating wounds (MFWs) must incorporate patient and family goals of care in all aspects of decision-making. People with MFWs suffer from a devastating and often crippling symptom burden including disfigurement, pain, pruritus, malodor, exudates, and bleeding. These symptoms may lead to psychosocial and/or spiritual distress, isolation, and diminished quality of life. The complexity of caring for hospice patients with MFWs requires a pragmatic and holistic interdisciplinary approach guided by specialist-level palliative wound care. This article introduces a framework to assist clinicians in the assessment and management of terminally ill patients with MFWs.