'Not Giving Up Yet': Palliative Care in the Elderly

Betty R. Ferrell, PhD, RN

Disclosures

September 09, 2016

Palliative Care in Geriatrics

There are many indications for palliative care in Nina's case, and initiating palliative care now can help her as she begins cancer treatment. Palliative care should not take away hope, but is intended to help Nina identify and meet her goals of care. Palliative care should not be delayed until after her treatment, because geriatric patients beginning chemotherapy and those with recurrent disease can benefit from palliative care to address side effects of therapy, treat symptoms of advanced disease, and anticipate needs that may occur as disease progresses. And although relief of pain may be a priority, palliative care should address all of Nina's concerns, including physical needs, function, psychosocial needs, and spiritual concerns.

There is ever-increasing awareness of the need for integrating palliative care into disease-focused therapies, and a key population that can benefit from palliative care is the elderly. In Nina's case, several concerns will be best addressed with collaboration between the palliative care team and her oncologist. Careful geriatric assessment will be vital to monitor her functional status.[1,2]

Nina's key concern about being able to continue caring for her husband will also influence future decisions. As with many older adults, Nina's children are at a distance, and they may need to be included in decisions about care for their mother and father.

With the increasing population of elderly persons, a growing number of treatment options, and better supportive care, it is likely that more elderly patients will opt to have chemotherapy.[3,4]Palliative care can support the patient through this phase, and early integration can also help the palliative care team to know the patient and be prepared to assist in achieving patient and family goals of care.[5]

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