Ageing, Dementia and Palliative Care
Palliative care for older people is well and truly on Australian and international health agendas. In Australia, a range of projects that have focused on older adults have been funded as part of the National Palliative Care Strategy, including:
- Development of the national Guidelines for a Palliative Approach in Residential Aged Care
- Community care
- Educational resources for health professionals working with older adults in residential aged care
- Formation of the Residential Aged Care Palliative Approach Network.
Internationally, the World Health Organization (WHO) has recognised the importance of palliative care for older people with the publication of a document – Better Palliative Care for Older People. However, despite this there is evidence that older adults with cancer are less likely to be referred to a specialist palliative care service suggesting that equity of access remains an issue. The palliative care needs of older people are often more complex than those of younger people. Older people are more likely to have multiple medical problems which can lead to greater impairment, increased care needs, a greater risk of adverse drug reactions and iatrogenic illness. This chapter specifically focuses on the palliative care needs of older people including people living with dementia. To comprehensively discuss all the palliative care needs of this group is not possible. Rather, this chapter discusses the most pressing issues, including: advance care planning; some common symptoms; and family care. Specific issues for people living with dementia are incorporated into each section. Prior to discussing these topics a brief overview of the common causes of death and where death occurs for older adults in Australia is presented.
- Death in old age: what do people die from
- Death in old age: where do people die?
- Advance care planning
- Advance care planning for people with dementia
- Common symptoms of older people dying requiring palliative care