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End-of-Life Care of Older Adults

  • Lara M. SkarfEmail author
  • Andrea Wershof Schwartz
Chapter

Abstract

Serious illness and end-of-life issues are challenging areas for clinicians caring for older adults. Patients may benefit from services offered by hospice, which cares for patients in the last 6 months of life, as well as palliative care, which offers an interdisciplinary approach focused on symptom management and supportive care for patients with serious illness of any time course. This chapter discusses indications for when it is appropriate to consider palliative care or hospice referrals for geriatric patients, as well as introducing prognostication tools available to guide these decisions and conversations. Some patients at the end of life may suffer from symptoms amenable to palliation, and others may decide to forgo or withdraw potentially life-prolonging treatments depending on their goals of care. The ethical challenge of requests for hastening death is discussed in addition to the ethical aspects of physician aid-in-dying legislation.

Keywords

Palliative care Hospice Prognostication End of life Death and dying 

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Additional Recommended Reading

  1. Blinderman CD, Billings JA. Comfort care for patients dying in the hospital. N Engl J Med. 2015; 373:2549–61.Google Scholar
  2. Kelley AS, Morrison RS. Palliative care for the seriously ill. N Engl J Med. 2015;373:747–55.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Harvard Medical School and Section of Geriatrics and Palliative Care, Medical ServiceVA Boston Healthcare SystemBostonUSA
  2. 2.Harvard Medical School and Section of Geriatrics and Palliative Care and GRECCVA Boston Healthcare SystemBostonUSA

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