Abstract
Although numerous studies have been conducted previously on the needs of cancer patients at the end of their life, there is a lack of studies focused on older patients with non-oncological complex chronic multipathologies. Examining these needs would help to gain a greater understanding of the profile of this specific population within the palliative care (PC) pathway and how the health and care systems can address them. The aim of this review was to identify the needs influencing PC among older patients with multimorbidities, their relatives or informal caregivers, and the health professionals who provide care for these patients. A scoping literature review guided by the Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist was carried out with literature searched in the Medline, Embase, CINAHL, WoS, Cochrane Library, PsycINFO, and Scopus databases from 2009 to 2022. Eighty-one studies were included, demonstrating a great variety of unaddressed needs for PC among chronic older patients and the complexity in detecting those needs and how to refer them to PC pathways. This review also suggested a scarcity of tools and limited pathways for professionals to satisfy their needs for these patients and their families, who often felt ignored by the system. Substantial changes will be needed in health and care systems at the institutional level, providing more specialized PC environments and systematizing PC processes.
Highlights
In 1990, the World Health Organization (WHO) adopted the definition proposed by the European Association for Palliative Care (EAPC) as the total active care of patients whose disease does not respond to curative treatment
There are numerous studies that have been previously conducted on the needs of cancer patients at the end of their life, such as Bandieri [7], Haun [5], and Wang [8], there is a lack of studies focusing on older patients with non-oncological complex chronic multipathologies, this study has focused on the needs of this profile of patients
In line with the results reported by Mathews et al [97], where the integration of specialized palliative care with oncology patients was analysed, health professionals agreed that integrated PC services are the desired care models to facilitate integration and coordination of care using an interdisciplinary approach [74,77,78]
Summary
Received: 31 December 2021Accepted: 3 March 2022Published: 8 March 2022Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.Licensee MDPI, Basel, Switzerland.Attribution (CC BY) license (https://creativecommons.org/licenses/by/ 4.0/).The palliative care (PC) concept has undergone changes and evolution in related conceptual and strategic approaches, including their use in clinical practice, in recent years. Conceptually, in 1990, the World Health Organization (WHO) adopted the definition proposed by the European Association for Palliative Care (EAPC) as the total active care of patients whose disease does not respond to curative treatment. The control of pain and other symptoms, as well as psychological, social, and spiritual problems, is paramount. The
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