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Palliative medicine and care of the elderly 

Palliative medicine and care of the elderly
Chapter:
Palliative medicine and care of the elderly
Author(s):

Meera Agar

and Jane L. Phillips

DOI:
10.1093/med/9780199656097.003.0163
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date: 07 May 2021

Palliative care in the older person occurs in the context of chronic disease and multimorbidity. Coexisting conditions include musculoskeletal, psychiatric, cognitive, and chronic pain-related problems, each associated with substantive symptomatology and disability. Most crucial is to avoid management within disease ‘silos’ and the risks associated with polypharmacy, which both contribute to adverse outcomes. The complexity of older people’s care demands the formation of a collaborative partnership between primary care, geriatric, and palliative care services, together with other health-care providers in accordance with need. The caregiver of the older person warrants specific mention, often an older spouse with their own medical problems or an adult child juggling other life and work commitments. Planning for care in advance is crucial to avoid decisions being made in crisis, and is particularly crucial if cognitive decline is predicted. Physiological changes, and the frequency of falls, frailty, depression, and delirium are important when planning care and prescribing.

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