Symptom assessment and management at the end of life

Abstract

As people age, the number and complexity of illnesses they develop increases. Symptoms during the last year of life in older persons are often a combination of the underlying life-threatening illness and other chronic conditions. These may be complicated by psychosocial and spiritual needs, related to life events such as bereavement. Geriatric palliative medicine involves the care and management of older patients’ progressive advanced disease, for whom the aim is quality of life. It focuses on detailed geriatric assessment, relief from pain and other symptoms such as anorexia, constipation, or delirium, and also management of psychological problems including depression or anxiety. This may be more challenging in people with cognitive impairment who may not be able to express whether they are in pain or otherwise suffering. Adequate pain and symptom management at the end of life emphasizes the need for a tailored multidisciplinary approach for patients and their family.