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Principles of Geriatric Palliative Care

Teaser: 

Albert J. Kirshen, MD, FRCPC,

(Internal, Geriatric, Palliative Medicine), Emeritus Associate Professor, Dept. of Family and Community Medicine, Faculty of Medicine, University of Toronto, formerly consultant palliative care physician, The Temmy Latner Centre for Palliative Care, Interdepartmental Division of Palliative Care, Sinai Health System, Toronto, ON.

CLINICAL TOOLS

Abstract: Palliative care aims to relieve suffering and enhance the quality of life for those with chronic, progressive or life-threatening illnesses. However, seniors' palliative care needs are often poorly recognized, assessed, or managed, resulting in adverse outcomes. This article explores the importance of recognizing, assessing, and managing symptoms for older adults needing palliative care. It offers insights into how physicians and healthcare providers can improve the quality of life for seniors by addressing their pain and symptom management needs.
Key Words: palliative care, symptom management, older adults, geriatrics, pain management, quality of life, recognition, assessment.
Palliative care aims to improve the quality of life for seniors with chronic, progressive or life-threatening illnesses.
Healthcare providers need to tailor symptom management to the unique characteristics of older adults, including cognitive and sensory impairments.
Recognition, assessment, and management of symptoms are critical components of palliative care.
A comprehensive approach that includes communication, pharmacological and non-pharmacological interventions can improve the quality of life for seniors in need of palliative care.
Communication with patients, caregivers, and other healthcare professionals is key to recognizing seniors’ palliative care needs.
Assessment of seniors’ symptoms should be tailored to their unique characteristics, including cognitive and sensory impairments.
A comprehensive approach that includes pharmacological and non-pharmacological interventions is essential for optimal symptom management in seniors.
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Related Terms: Caregiving, palliative care, symptoms, management, older adults, geriatric, pain management, quality of life, recognition, assessment

Beyond Sad Mood: Alternate Presentations of Major Depression in Late Life

Beyond Sad Mood: Alternate Presentations of Major Depression in Late Life

Teaser: 



Tony Lo, MD, Resident, Department of Psychiatry, University of Calgary, Calgary, AB.
Nadeem H. Bhanji, BSc(Pharm), MD, FRCP(C), Assistant Professor, University of Calgary; Staff Psychiatrist, Carewest Glenmore Rehabilitation Hospital; Elderly Psychiatrist, Department of Psychiatry, Peter Lougheed Centre; Assistant Professor, University of Calgary, Calgary, AB.

Major depression and subsyndromal depression are common in older persons. Unrecognized depression results in increased morbidity and mortality. Recognition of depression is challenging due to patient- and clinician-related factors. Diagnosis in the older person is confounded by medical comorbidities as well as normal changes. Depression in older adults manifests differently: somatic complaints, nonspecific symptoms, and cognitive difficulties are common, as are behavioural changes, including apathy and irritability. Anhedonia better reflects depression, since depressed mood is often denied by the older person. Depression is likely to be missed if only typical symptoms are sought. Appropriate recognition can lead to improved treatment and outcomes.
Key words: depression, older adult, diagnosis, recognition, management.

Related Terms: Mental Health, depression, diagnosis, management, older adults, recognition