Palliative Care: Older Adults

Palliative care for elders are differs from what is usually appropriate in adults because of the nature and duration of chronic illness during old age. Care for the patient would include chemotherapy until it no longer meets the patient's goals of care; treating those symptoms (e.g., nausea, pain, fatigue); addressing her psychological and spiritual concerns; supporting her partner; and helping to arrange for care of children after them dead. The majority of the patient's care occurs at home (with or without hospice) or in the hospital, and the period of functional debility is brief (months). In reality, a frail 88-year-old widowed woman with advanced heart failure, diabetes mellitus, osteoarthritis, mild cognitive impairment, and frailty typifies the most common example of a patient requiring palliative care.

                         

Palliative care for patient involves treating the primary disease process (advanced heart failure); managing her multiple chronic medical conditions and comorbidities (diabetes mellitus, arthritis) and geriatric syndromes (cognitive impairment, frailty), assessing and treating the physical and psychological symptom distress associated with all of the medical issues; and establishing goals of care and treatment plans in the setting of an unpredictable prognosis. Additionally, the needs of caregiver(s) are also different from those of the caregiver of the younger patient. Individual caring for geriatric patients are often adult children with their own families, work responsibilities, and medical conditions. The roles must be balanced with the months to years of personal care that they will provide to their aging parent. Lastly the older adults often make multiple transitions across care settings (home, hospital, rehabilitation, long-term care), especially in the last months of life, palliative care programs for older adults must know that care plans and patient goals are maintained from one setting to another.

Thus, palliative care for the elderly is centered on the identification and amelioration of functional and cognitive impairment; the development of frailty leading to dependence on caregivers; symptom, emotional, and spiritual distress; and bereavement needs of adult children and elderly partners.

For more details: https://healthcare.nursingmeetings.com/