GERONTOLOGICAL ASPECTS AND PALLIATIVE CARE IN FAMILY MEDICINE

Abstract

This article presents a literature analysis on the gerontological aspects of comorbidity and the provision of palliative care in the practice of a family doctor. According to the UN, in 2020, the age of almost every tenth inhabitant of the Earth exceeded 65 years. In 2050, their share will increase from 9.3% to 15.9%. The share of people aged 60 and over will make up to one third of the global population. Analysis of referrals to outpatient polyclinic institutions shows that, in general, for all classes of diseases and individual diseases, the highest percentage of referrals to a doctor is observed in groups of 70 years and older. In old age, both physiological and pathological aging are accompanied by structural and functional changes of all organs and systems, hemodynamic disturbances, deterioration of blood supply to tissues, increased risk of hypoxia with early activation of anaerobic mechanisms. Among those who seek medical help from a family doctor in Ukraine, the share of elderly patients with combined pathology is more than 80%. Elderly people with comorbid conditions experience pain more frequently than those in other age groups. One of the primary medical, social and humanitarian problems of many countries throughout the world is the creation and development of an accessible and effective system of providing palliative care to the population. These problems arose due to an increase in the number of incurable patients with a limited life expectancy. Based on the analysis of the experience of different countries, it is convincingly clear that palliative and hospice care best provides the needs and proper quality of life of palliative patients and their relatives, contributes to the preservation of human dignity at the end of biological life. The goal of palliative care is to alleviate the suffering of patients and their families by comprehensively assessing and treating the physical, psychosocial, and spiritual symptoms experienced by patients. Palliative care focuses on predicting, preventing, diagnosing, and treating the symptoms experienced by patients with serious or life-threatening illness, and on helping patients and their families make important medical decisions. A family doctor is recognized as a specialist in the medical field who can most fully influence the health of the population. Family doctors provide palliative care, they consult, educate relatives and friends of the patient about the patient's needs, provide psychological and moral support to both the patient and his family.