Geriatric Palliative Care

Original Editor - Lucinda Hampton

Top Contributors - Lucinda hampton and Kapil Narale  

Introduction[edit | edit source]

Geriatric palliative care (GPC) can be defined as care that "integrates the complementary specialties of geriatrics and palliative care to provide comprehensive care for older patients entering the later stage of their lives, and their families." [1]

GPC is an emerging field and many aspects of its implementation are still being developed. This has come about as populations globally are aging and the last era of life stretches out now to a long phase. This last phase is distinguished by complex treatment decisions, difficult symptom management, numerous psychosocial issues and often overlooked inner distress.[2]

GPC is relevant and will be beneficial to the older person with an illness or condition that is likely to affect their longevity, or if they are becoming frail.

Physiotherapists often have a role in geriatric palliative care focusing on eg. Pain management, strengthening when possible, energy conservation and ADL simplification. See Physiotherapy in Palliative Care.

Differing Needs[edit | edit source]

Geriatric patients have distinct needs that distinguish their care from younger individuals. Evidence suggests that, likewise, their palliative care needs differ. eg different prevalence and intensity of symptoms, more recurring neuropsychiatric challenges, greater social needs, and complex medicolegal and ethical issues.

The boundaries between geriatrics and palliative care are unclear and often overlap. Unfortunately there exists limited understanding between the two disciplines in regard to what each discipline can offer the other. Research seems to suggest more communication and dialogue is needed between these disciplines for the mutual benefit of the clients.[3]

Palliative care is fitting for any geriatric patient with a serious illness, regardless of prognosis or time to end of life.[4]

Home Based Geriatric Palliative Care[edit | edit source]

Many homebound individuals are geriatrics with multiple chronic conditions eg cognitive impairment, neurodegenerative disorders, cardiovascular disorders, or frailty. These individuals may be homebound and additionally chair- or bed-bound, and their prognosis may be quite limited. Home-based Palliative Care has an increasing amount of literature that supports the benefits of this form of palliative care. It appears beneficial to patients, families, and informal caregivers by lessening symptoms, minimising unwanted hospitalisations, and offering support at the end of life.[2]

References[edit | edit source]

  1. Goldhirsch S, Chai E, Meier DE, Morris J. Geriatric palliative care : a practical guide for clinicians. New York: Oxford University Press; 2014.Available:https://books.google.com.au/books?hl=en&lr=&id=8LkoAwAAQBAJ&oi=fnd&pg=PP1&ots=-GCakpu4E5&sig=Os1dHsFLLybUGTgoANzbb26og6M&redir_esc=y#v=onepage&q&f=false (accessed 2.1.2023)
  2. 2.0 2.1 Roberts B, Robertson M, Ojukwu EI, Wu DS. Home based palliative care: Known benefits and future directions. Current Geriatrics Reports. 2021 Dec:1-7.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8614075/ (accessed 2.11.2023)
  3. Visser R, Borgstrom E, Holti R. The overlap between geriatric medicine and palliative care: A scoping literature review. Journal of Applied Gerontology. 2021 Apr;40(4):355-64. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961659/Accessed 2.11.2023
  4. Santivasi WL, Partain DK, Whitford KJ. The role of geriatric palliative care in hospitalized older adults. Hospital Practice. 2020 Mar 31;48(sup1):37-47.Available: https://www.tandfonline.com/doi/full/10.1080/21548331.2019.1703707 (accessed 2.11.2023)