Palliative care for frail older people

The “surprise question” for predicting death in seriously ill patients: a systematic review and meta-analysis

“…46 This discomfort is an important problem for a test that depends on clinician participation. Third, the poorer sensitivity and positive likelihood ratio in patients with noncancer illness, such as those with end-stage organ failure and frailty, 47,48 suggests that the SQ may be particularly unhelpful in this population. Fourth, physicians may be reluctant to commit to a positive answer on the SQ even if they suspect that the patient is dying.…”

Enabling at-homeness for residents living in a nursing home: Reflected experience of nursing home staff

“…In 2012, the most common causes of death among all the registered deaths in Swedish nursing homes were circulatory diseases, dementia and cancer (Smedbäck et al, 2017). However, it is common that older people suffer from more than one life-limiting illness, which together might contribute to death (Pal & Manning, 2014;WHO, 2011). As earlier described, the most common causes of death for older people in Europe and Swedish nursing homes, such as circulatory diseases, respiratory diseases, cancer and dementia, were also the diseases that participants in this thesis suffered from and what is referred to here as severe illness.…”

“…Since it has been regarded that older people's deaths can be difficult to predict and especially to identify, when the last period before death begins (Covinsky et al, 2003), instruments such as the conception of frailty have been developed. Comorbidities and disabilities have often been related to being part of the definition of frailty (Lekan, 2009) and it has been recognized that frail older people often have more than one life-limiting illness and are in need of care with a palliative approach (Pal & Manning, 2014). In addition, vulnerability and aging have been included as key elements in the concept of frailty; however there is a lack of mutual consensus surrounding this concept (Gobbens, Luijkx, Wijnen-Sponselee, & Schols, 2010).…”

Asian collaboration to establish a provisional system to provide high‐quality end‐of‐life care by promoting advance care planning for older adults

“…1). 8 Concurrent with the rapid and significant progress in palliative medicine, the EOL period has expanded. However, for clarification of the distinction between ACP and EOL communication, we define EOL in this Letter as the period covering the final stage of life.…”

“…12 The authors learned that it is appropriate to offer ACP at any time of life, particularly according to the progression of frailty, not chronological age, at the GSF meeting in London in 2015. 8 As Asians with rapidly aging societies, we share similar cultures and traditions deeply influenced by Confucianism and ancient Chinese culture. We believe that immediate cooperation is essential in responding to the increasing health and long-term care needs of the elderly at EOL.…”