Table 3 Results of literature search "end of life needs of the elderly"
From: Palliative care for the elderly - developing a curriculum for nursing and medical students
Field | Topics |
|---|---|
Geriatrics | â—‹ Holistic approach is important [11]. â—‹ Even though a potential life limiting disease is present, common symptoms of old age like bladder control difficulties or impaired vision can cumulatively have a considerable negative effect on quality of life [25]. â—‹ Geriatric assessment and knowledge of common problems like falls, delir, fragility, incontinence and especially dementia [6, 21]. â—‹ Multimorbidity as a challenge for prognosis, e.g. leading to inefficient timing of hospice admission [7, 21]. |
Palliative Care | â—‹ Personal, psychological and existential issues have to be addressed [11, 17, 23]. â—‹ Cultural influence on personal, psychological and existential issues has to be considered [11]. â—‹ Efficient pain control is crucial [17, 24]. â—‹ Liberty from pain is necessary for personal, existential and spiritual issues to be addressed [24]. â—‹ Patients aged 70 and above need support in dealing with existential and spiritual issues despite their age [25]. â—‹ While treating symptoms, the fragile equilibrium of an elderly person's physiology has to be kept in mind at all times [7, 8, 21]. |
Communication and patient autonomy | â—‹ Effective communication between caretakers and patient leads towards improved health outcomes and quality of care [6, 8, 17]. â—‹ In dementia, it is crucial to plan and implement a plan of care while the patient is still able to do so. The family should be involved at an early stage [6]. â—‹ Communication with the patient's family is a necessary part of care work [22]. â—‹ The interprofessional team approach is important [11, 22]. |
Organisation and social networks | ○ Unlike patients in their mid-life segment, elderly people often have a weak social network. This leads to a lack of close persons who can be addressed with personal, existential and spiritual issues, also less support in organisational issues e.g. through family members is accessible [8]. ○ A key worker can help improve the organisation of care [17]. ○ Patients have to be educated and aided by caretakers to develop and implement a thorough plan of care. Advance directives should be made [6–8]. ○ Elderly patients do wish to have more contact with their caretakers but often do not ask for it for fear of being a burden [23, 25]. |