Palliative Care and the Elderly

An article, “The TLC Model of Palliative Care in the Elderly: Preliminary Application in the Assisted Living Setting” in the Annals of Family Medicine, describes 5 barriers to palliative care with the elderly who live in assisted living facilities. We can definitely generalize this to most situations where the elderly would benefit from palliative care.

Basically, the 5 barriers to palliative care for them are:

• the perception that palliative care is only terminal care.
• palliative care is defined as mutually exclusive of cure directed treatment.
• the decision if palliative care should be the sole form of care is not ” … negotiated among patients, family members, and providers … “
• making treatment choices is given more importance than discussing the reality of life with a chronic debilitating illness
• palliative care is treated as an either/or decision instead of an integrated part of the treatment plan.

In a nutshell, palliative care is appropriate and possible regardless of which disease process a person has, what the prognosis is or what cure directed treatment choices a person makes. Palliative care should be interwoven concurrently with cure directed treatment. It can either be used with treatment intended to cure or as the sole form of treatment.

Palliative care (regardless of other treatment plans being used) optimizes quality of life and when your energies are not spent coping with pain, nausea, breathlessness, fatigue and the immobility (among other things) resulting from this, there is more energy to cope with the manifestations of the disease. When a person is comfortable, they eat more, sleep better, not as fatigued, not as depressed and at least have the possibility of enjoying their day.