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Geriatric Palliative Care

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Advanced Age Geriatric Care

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Abstract

The aims of palliative care at the end of life are largely the relief of pain and suffering. Palliative care is not limited to end-of-life care but strives to relieve suffering at all stages of disease. Hospice focuses attention on comfort care. Palliative care must be able to provide a wide range of services and embrace the need of patients from independent to those with multiple comorbidities, frailty and drawn-out dying. Clinicians often encounter an array of ethical issues relating to palliative care and end-of-life care, such as ethically intricate decision-making, patients’ wishes regarding treatment and quality of life.

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Author information

Authors and Affiliations

  1. Crown Princess Mary Cancer Centre, Westmead, NSW, Australia

    Jayasingham Jayamohan & Puma Sundaresan

  2. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

    Nages Nagaratnam

Authors
  1. Jayasingham Jayamohan
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  2. Puma Sundaresan
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  3. Nages Nagaratnam
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Editor information

Editors and Affiliations

  1. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

    Nages Nagaratnam

  2. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

    Kujan Nagaratnam

  3. Rehabilitation and Aged Care Service, Blacktown-Mt Druitt Hospital, Blacktown, NSW, Australia

    Gary Cheuk

Multiple Choice Questions

Multiple Choice Questions

  1. 1.

    An 88-year-old previously fit man presents with a 1-month history of dysphagia and odynophagia with solids. Endoscopic examination reveals a 4 cm circumferential lesion involving the mid-oesophagus and causing narrowing/obstruction. Biopsy of this lesion confirms squamous cell carcinoma. Staging investigations demonstrate two liver lesions suggestive of metastases. Which of the following interventions are appropriate to consider in this clinical scenario?

    1. A.

      Insertion of a stent to relief the obstruction

    2. B.

      Referral to dietician

    3. C.

      Symptomatic management of pain

    4. D.

      Short course of palliative radiotherapy

    5. E.

      All of the above

  2. 2.

    The following are true of palliative and hospice care, EXCEPT:

    1. A.

      Hospice focuses attention on comfort care.

    2. B.

      Palliative care is not limited to end-of-life care but strives to relieve suffering at all stages of disease.

    3. C.

      To be eligible for most hospice care, the patient is considered terminal or has 1 year to live.

    4. D.

      In the last 10 years or more, palliative care has been extended to include other life-limiting illnesses including dementia.

  3. 3.

    The following are true of patients receiving palliative care, EXCEPT:

    1. A.

      There is now general acceptance that palliative care needs of the elderly require particular consideration.

    2. B.

      Symptom control and quality of life can be improved by early access to palliative care.

    3. C.

      Symptom management and advance care planning are a high priority for these patients.

    4. D.

      Distinguishing between expected trajectories is not helpful to direct strategies.

  4. 4.

    The following are true of palliative sedation, EXCEPT:

    1. A.

      Palliative sedation is the use of medications when other treatments have failed.

    2. B.

      Palliative sedation remains a contentious issue.

    3. C.

      It is usually given for refractory pain, agitated delirium, dyspnoea and psychological distress.

    4. D.

      Palliative sedation is not aimed at bringing about a state of decreased awareness or absent awareness.

Answers to MCQs

  1. 1.

    E

  2. 2.

    C

  3. 3.

    D

  4. 4.

    D

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Jayamohan, J., Sundaresan, P., Nagaratnam, N. (2019). Geriatric Palliative Care. In: Nagaratnam, N., Nagaratnam, K., Cheuk, G. (eds) Advanced Age Geriatric Care. Springer, Cham. https://doi.org/10.1007/978-3-319-96998-5_13

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  • DOI: https://doi.org/10.1007/978-3-319-96998-5_13

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  • Online ISBN: 978-3-319-96998-5

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