Problems of terminal care in elderly patients

Abstract

The care given to 27 elderly men dying in a geriatric ward was examined and compared with terminal care directed to younger patients dying with cancer. Important practical differences were highlighted:

1) Difficulties in communication with elderly dying patients are frequently encountered and require heightened powers of observation of nonverbal information and empathy.

2) There is often little time for staff to provide effective terminal care for elderly patients. The diagnosis of dying is frequently made by exclusion, after failure of standard medical treatment. It is more difficult in the absence of neoplasia and requires a more holistic approach to patient care.

3) A significant proportion of elderly patients who die in hospital do not have family or friends to visit them and may require additional attention and support.

Keywords

communication barriers confusion palliative treatment social isolation terminal care

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References

Saunders CM , ed. The management of terminal illness. London: Edward Arnold, 1978.

Moon P. St Christopher's Hospice: 1987 Statistics (Personal communication).

Wilson JA , Lawson PM , Smith RG The treatment of terminally ill geriatric patients. Palliative Medicine 1987; 1: 149-53.

Graham H. , Livesley B. Dying as a diagnosis: difficulties of communication and management in elderly patients. Lancet 1983; 2: 670-72.

Exton-Smith N. Terminal illness in the aged. Br Med J 1961; 2: 305-308.

Hinton JM Physical and mental distress of the dying. Q J Med 1963; 32: 1-21.

Witzel L. Behaviour of the dying patient. Br Med J 1975 ; 2: 81-82.

Office of Population Censuses and Surveys. OPCS Monitor: Mid 1986 Population estimates for England and Wales; PP1 87/1. London: HMSO, 1987.