There is often a lack of adequate communication between health care providers and those facing terminal conditions, according to a series of articles in the latest issue of The Journal of Gerontology: Medical Sciences (Vol. 63, No. 3).
This topic is of concern to older adults, because they comprise the vast majority — about 70 percent — of those contending with multiple chronic medical problems.
The articles in question, representing four separate studies, point out the need to address treatment preferences and symptom burden among sufferers of advanced illness. The research highlights the importance of consistent, planned interactions with older adults and discussions about goals of care.
"The common theme is the large gulf between health care science, practices, and systems, and the understanding needed to deal with the issues faced by older patients regarding care preferences at the end of life," Darryl Wieland, PhD, MPH, of Palmetto Health Richland Hospital in Columbia, SC. He co-edited the special journal section in which the articles appear together with Christine S. Ritchie, MD, MSPH, of the University of Alabama – Birmingham.
Early discussions about treatment choices are especially encouraged, because many older adults have limitations in health literacy and cognitive capacity brought on by multiple chronic illnesses.
Under the banner of "Advanced Illness Care: Applications in Older Patients with Life-Limiting Illnesses," the contents of the special section are listed below:
Advanced Illness Care in Older Adults: Many Lessons Yet To Be Learned (Editorial)
Advance Care Planning and Health Care Preferences of Community Dwelling Elders: The Framingham Heart Study
Patient Age, Well-Being, Perspectives, and Care Practices in the Early Treatment Phase for Late-Stage Cancer
The Relationship of Reported Pain Severity to Perceived Effect on Function of Nursing Home Residents
Palliative Care Intervention for Choice and Use of Opiods in the Last Hours of Life