Better Palliative Care For Older People

Current projections indicate that by 2050 the number of people aged over 80 years old will rise to 395 million and that by this date 25-30% of people over the age of 85 will show some degree of cognitive decline. Palliative care for older people: A public health perspective provides a comprehensive account of the current state of palliative care for older people worldwide and illustrates the range of concomitant issues that, as the global population ages, will ever more acutely shape the decisions of policy-makers and care-givers. The book begins by outlining the range of policies towards palliative care for older people that are found worldwide. It follows this by examining an array of socio-cultural issues and palliative care initiatives, from the care implications of health trajectories of older people to the spiritual requirements of palliative care patients, and from the need to encourage compassion towards end-of-life care within communities to the development of care pathways for older people. Palliative care for older people: A public health perspective is a valuable resource for professionals and academics in a range of healthcare and public health fields to understand the current state of policy work from around the world. The book also highlights the social-cultural considerations that influence the difficult decisions that those involved in palliative care face, not least patients themselves, and offers examples of good practice and recommendations to inspire, support, and direct healthcare policy and decision-making at organisational, regional, national and international levels.

Ageing populations mean that palliative and end of life care for older people must assume greater priority. Indeed, there is an urgent need to improve the experiences of older people at the end of life, given that they have been identified as the 'disadvantaged dying'. To date, models of care are underpinned by the ideals of specialist palliative care which were developed to meet the needs of predominantly middle-aged and 'young old' people, and evidence suggests these may not be adequate for the older population group. This book identifies ways forward for improving the end of life experiences of older people by taking an interdisciplinary and international approach. Providing a synergy between the currently disparate literature of gerontology and palliative care, a wide range of leading international experts contribute to discussions regarding priority areas in relation to ageing and end of life care. Some authors take a theoretical focus, others a very practical approach rooted in their clinical and research experience. The issues covered are diverse, as are the countries in which discussions are contextualised. Those working in both palliative care and gerontology will find the issues and advice discussed in this book hugely topical and of real practical value.

Populations around the world are ageing and more people are living with the effects of serious chronic illness towards the end of life. This publication provides examples of better palliative care practices, from or relevant to the WHO European Region, that range from a whole health system perspective down to individual examples of better education or support in the community and elsewhere. While some examples remain to be fully evaluated, they will nevertheless help policy-makers, decision-makers, planners and multidisciplinary professionals to plan and support the most appropriate and effective services for the care and quality of life of older people.

Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform provides an introduction to the principles of palliative care; describes current models of delivering palliative care across care settings, and examines opportunities in the setting of healthcare policy reform for palliative care to improve outcomes for patients, families and healthcare institutions. The United States is currently facing a crisis in health care marked by unsustainable spending and quality that is poor relative to international benchmarks. Yet this is also a critical time of opportunity. Because of its focus on quality of care, the Affordable Care Act is poised to expand access to palliative care services for the sickest, most vulnerable, and therefore most costly, 5% of patients- a small group who nonetheless drive about 50% of all healthcare spending. Palliative care is specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness—whatever the diagnosis or stage of illness. The goal is to improve quality of life for both the patient and the family. Research has demonstrated palliative care’s positive impact on health care value. Patients (and family caregivers) receiving palliative care experience improved quality of life, better symptom management, lower rates of depression and anxiety, and improved survival. Because patient and family needs are met, crises are prevented, thereby directly reducing need for emergency department and hospital use and their associated costs. An epiphenomenon of better quality of care, the lower costs associated with palliative care have been observed in multiple studies. Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform, a roadmap for effective policy and program design, brings together expert clinicians, researchers and policy leaders, who tackle key areas where real-world policy options to improve access to quality palliative care could have a substantial role in improving value.

The growing geriatric population in the United States has created an increasing need for palliative medicine services across the range of medical and surgical specialties. Yet, palliative medicine lacks the resources to carry such a workload itself. Geriatric Palliative Care addresses this need by encouraging individual specialties to "own" the management of elderly with the same vigor as they "own" other key management competencies within their specialty. This clinically focused and highly practical handbook, which compliments the more comprehensive text Geriatric Palliative Care by Sean Morrison and Diane Meier (Oxford University Press, 2003), encourages this process of learning and ownership across many medical specialties. Designed to be readable and easily accessible to a range of health care providers, Geriatric Palliative Care outlines specific strategies for caring for specific palliative care issues common in elderly patients. The handbook also provides evidence based advice for helping patients, relatives, and staff cope with such issues as polypharmacy, dementia and consent, multiple pathologies, home care, elderly caregivers, and supporting the elderly in the place where they would like to be.

In this work, contributors from nursing and medicine, from the social and health sciences, and from ethics and health planning provide an international perspective on key issues in relation to end-of-life care such as: assessment; loss, autonomy and the ethics of end-of-life decision making.

Geriatric Palliative Care covers a broad spectrum of issues characterizing care near the end of life for older adults. Beginning with the social and cultural context of old age and frailty, this volume details specific aspects of palliative care relevant to particular disorders (e.g. cancer, strokes, dementia, etc.) as well as individual symptoms (e.g., pain, fatigue, anxiety, etc.). Communication between care-givers and patients, in a variety of settings, is also discussed. The theme of this book is that palliative care is the best approach to the care of chronically ill and frail elderly because of its focus on: quality of life; support for functional independence; and the centrality of the patient's values and experiences in determining the goals of medical care. Indeed, Geriatric Palliative Care provides a comprehensive medical reference for all clinicians who care for older adults.