Geriatrics and Palliative Care: Collaboration for Quality of Life Until Death

Elaine J. Amella, PhD, APRN, BC

Disclosures

Journal of Hospice and Palliative Nursing. 2003;5(1) 

In This Article

Abstract and Introduction

Nurses specializing in geriatrics and palliative care share a common goal: Above all else they will help the patient to experience the best quality of life. However, nurses specializing in palliative care may not be aware of the numerous ways that the aging process alters health problems. This review article addresses ways that symptoms of illness and altered presentation of disease may occur in the very old or frail adult. Appropriate assessment instruments for screening or evaluating older adults are shared. Psychosocial issues for both dying older adults and their caregivers are discussed. Finally, evidence-based health promotion recommendations for the end of life are given.

Gerontology takes its origins from the Greek word geront, meaning 'old man.' Geriatrics is a health discipline 'encompassing psychosocial, economic, historical, and physiological factors'[1] for adults 65 and older. With its origins in the United Kingdom credited to Dr. Marjorie Warren, geriatrics focuses on two principal goals: fostering independence or control over life and preserving quality of life. It achieves these goals through a collaborative care model involving health and social service disciplines. Not surprisingly, the palliative care movement also arose in Britain through the pioneering work of another woman, Dame Cicely Saunders, a nurse, physician, and social worker, who focused on comfort care. Palliative care is defined by the World Health Organization as 'the active total treatment of patients whose disease is not responsive to curative treatment.'[2] Both of these care models share similar goals and accomplish them through an interdisciplinary team effort.

Health professionals caring for older persons at the end of life may have preparation either in the field of palliative care or geriatrics, but usually not in both fields. This article presents a perspective of caregiving unique to older adults: geriatrics. It discusses how both symptoms of illness and dying may be different in the very old or frail adult, and melds geriatrics and palliative care to discuss health problems that may occur toward the end of life.

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