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Palliative Care for Older People
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Palliative Care for Older People

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 5346

Special Issue Editor

Prof. Dr. Liv Wergeland Sørbye

E-Mail Website
Guest Editor
Department of Health, VID Specialized University, NO-0319 Oslo, Norway
Interests: palliative care; old people; end of life

Special Issue Information

Dear Colleagues,

Dame Cicely founded St Christopher’s Hospice in London in 1967. This was the first hospice combining expert pain and symptom control, compassionate care, teaching and clinical research [1]. Palliative care is an active treatment, nursing and care for patients with incurable diseases and short life expectancies. Care for older people includes the relief of physical pain and other troublesome symptoms. In addition, older people need help verbalizing mental, social and existential problems. The World Health Organization states that 78% of adults in need of palliative care live in low- and middle-income countries [2]. We may assume that for the oldest people in these countries, the possibility of receiving adequate palliative care is scarce. Most articles concerning palliative care are mainly about cancer in younger people and articles on older persons suffering from cancer are more seldom [3]. Research studies on people with dementia, nearing the end of life, tend to use definitions of what constitutes good care from cancer models without analyzing which elements are transferable and which are not [4]. Furthermore, chronic obstructive pulmonary disease (COPD) leads to high morbidity and mortality in older patients. However, many older patients do not receive timely end-of-life care consultations with healthcare professionals [5]. Ultimately, at the end of life, no one ought to die alone.

References

  1. Christopher https://www.stchristophers.org.uk/about/damecicelysaun
  2. World Health Association. Palliative Care , 2020 https://www.who.int/health-topics/palliative-care
  3. Huynh L, Moore J. Palliative and end-of-life care for the older adult with cancer. Curr Opin Support Palliat Care. 2021 Mar 1;15(1):23-28. doi: 10.1097/SPC.0000000000000541. PMID: 33507037.
  4. Amador S, Sampson EL, Goodman C, Robinson L; SEED Research Team. A systematic review and critical appraisal of quality indicators to assess optimal palliative care for older people with dementia. Palliat Med. 2019 Apr; 33(4):415-429. doi: 10.1177/0269216319834227. Epub 2019 Mar 11. PMID: 30854933; PMCID: PMC6439949.
  5. Čičak P, Thompson S, Popović-Grle S, Fijačko V, Lukinac J, Lukinac AM. Palliative and End-of-Life Care Conversations with Older People with Chronic Obstructive Pulmonary Disease in Croatia-A Pilot Study. Healthcare (Basel). 2020 Aug 20;8(3):282. doi: 10.3390/healthcare8030282. PMID: 32825316; PMCID: PMC7551859

Prof. Dr. Liv Wergeland Sørbye
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • older people
  • end of life
  • palliative care
  • conversations
  • loneliness
  • death and dying

Published Papers (3 papers)

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Research

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9 pages, 1028 KiB  
Article
Information and Advance Care Directives for End-of-Life Residents with and without Dementia in Nursing Homes
by Emilio Mota-Romero, Olga Rodríguez-Landero, Rocío Moya-Dieguez, Glaucione Marisol Cano-Garzón, Rafael Montoya-Juárez and Daniel Puente-Fernández
Healthcare 2023, 11(3), 353; https://doi.org/10.3390/healthcare11030353 - 26 Jan 2023
Cited by 1 | Viewed by 1794
Abstract
Background: Communication and advance care directives may be affected by the presence of dementia. We sought to describe the information and end-of-life preferences provided to nursing homes residents and their families. Methods: Trained nurses collected information from 124 residents randomly selected with palliative [...] Read more.
Background: Communication and advance care directives may be affected by the presence of dementia. We sought to describe the information and end-of-life preferences provided to nursing homes residents and their families. Methods: Trained nurses collected information from 124 residents randomly selected with palliative care needs from eight nursing homes. Results: A total of 54.4% of the residents with dementia had been provided with information about their state of health, compared to 92.5% of the residents without dementia (p < 0.01); family members exhibited no differences regarding information (p = 0.658), regardless of whether the resident was cognitively impaired. Most advance care interventions remained unexplored, except for cases where a transfer to hospital (81.5%) or serotherapy (69.4%) was desired. Decisions regarding palliative sedation (p = 0.017) and blood transfusion (p = 0.019) were lower among residents with dementia. Conclusions: Residents, especially residents with dementia, are provided with limited information and their preferences are inadequately explored. Full article
(This article belongs to the Special Issue Palliative Care for Older People)
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10 pages, 252 KiB  
Article
The Experiences and Views on Palliative Care of Older People with Multimorbidities, Their Family Caregivers and Professionals in a Spanish Hospital
by Laura Llop-Medina, Francisco Ródenas-Rigla, Jorge Garcés-Ferrer and Ascensión Doñate-Martínez
Healthcare 2022, 10(12), 2489; https://doi.org/10.3390/healthcare10122489 - 9 Dec 2022
Viewed by 1313
Abstract
The increasing prevalence of complex chronic diseases in the population over 65 years of age is causing a major impact on health systems. This study aims to explore the needs and preferences of the multimorbid patient and carers to improve the palliative care [...] Read more.
The increasing prevalence of complex chronic diseases in the population over 65 years of age is causing a major impact on health systems. This study aims to explore the needs and preferences of the multimorbid patient and carers to improve the palliative care received. The perspective of professionals who work with this profile of patients was also taken into account. A qualitative study was conducted using semi-structured interviews with open-ended questions. Separate topic guides were developed for patients, careers and health professionals. We included 12 patients, 11 caregivers and 16 health professionals in Spain. The results showed multiple unmet needs of patients and families/caregivers, including feelings of uncertainty, a sense of fear, low awareness and knowledge about palliative care in non-malignant settings, and a desire to improve physical, psychosocial and financial status. A consistent lack of specialized psychosocial care for both patients and caregivers was expressed and professionals highlighted the need for holistic needs assessment and effective and early referral pathways to palliative care. There is a lack of institutional support for multimorbid older patients in need of palliative care and important barriers need to be addressed by health systems to face the significant increase in these patients. Full article
(This article belongs to the Special Issue Palliative Care for Older People)

Review

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9 pages, 898 KiB  
Review
How to Accommodate the Emotional Dimensions of Advance Care Planning Using Motivational Interviewing and Conditional Medical Orders
by Richard B. Stuart, George Birchfield and Stephen Thielke
Healthcare 2022, 10(11), 2257; https://doi.org/10.3390/healthcare10112257 - 11 Nov 2022
Viewed by 1608
Abstract
Palliative care discussions offer a unique opportunity for helping patients choose end-of-life (EOL) treatments. These are among the most difficult decisions in later life, and protecting patients’ ability to make these choices is one of healthcare’s strongest ethical mandates. Yet, traditional approaches to [...] Read more.
Palliative care discussions offer a unique opportunity for helping patients choose end-of-life (EOL) treatments. These are among the most difficult decisions in later life, and protecting patients’ ability to make these choices is one of healthcare’s strongest ethical mandates. Yet, traditional approaches to advance care planning (ACP) have only been moderately successful in helping patients make decisions that lead to treatments concordant with their values. In particular, neglect of attention to the emotions that occur during consideration of the end of one’s life contributes to patients’ difficulty with engaging in the process and following through on decisions. To improve ACP outcomes, providers can address the patient’s emotional experiences, and can use motivational interviewing as a way attend to elicit them and incorporate them into care planning. Applying personalizing emotion-attuned protocols like Conditional Medical Orders (CMO) also promotes this end. Full article
(This article belongs to the Special Issue Palliative Care for Older People)
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