Characteristics of palliative care in the elderly

Abstract

Palliative care for elderly, mostly multimorbid people is an integrative concept that is included at an early stage of illness in addition to curative and rehabilitative treatments. Goals of treatment and in the rest of life are regularly discussed during the course in order to set individual priorities and to plan or question clarifications, treatments and nursing measures. The prognosis, the patient's wishes and values, the possible benefits and burdens of an intervention play a central role in the decision-making process. Advance care planning makes it easier to make decisions at a later stage, especially in the case of dementia, which increasingly impairs the ability to make judgments. Older people suffer not only from destressing symptoms such as pain, but also from functional limitations that affect their quality of life. In addition to symptom-alleviating interventions, rehabilitative measures are also part of the palliative concept. In pain treatment, age-adapted adjustments to the medication are to be considered and the multidimensionality of the pain experience must be taken into account. In the case of cognitive impairment, appropriate observation tools help to identify possible pain. In the context of dementia, palliative treatment of neuropsychiatric symptoms should be considered if the patient suffers from them.