Abstract
The terminal phase of many chronic GI conditions in the elderly requires careful attention to symptom management. Palliative care provides both a framework, centered on function, and techniques to address common issues such as anorexia, constipation, and intestinal obstruction. Such interventions are not necessarily focused solely on survival but rather on patient well-being during end-of-life care. In this respect, palliative care shares many goals of care with hospice, though unlike hospice, palliative care can be appropriate throughout the course of an illness.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Merriam-Webster Collegiate Dictionary. 10th ed. Springfield: Merriam-Webster; 2001.
Dunn GP. Palliative care: a promising philosophical framework for gastroenterology. Gastroenterol Clin North Am. 2006;35:1–21.
Bakitas M, Doyle Lyons K, Hegel M, et al. Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer. JAMA. 2009;302(7):741–9.
Gade G, Venohr I, Conner D, et al. Impact of an inpatient palliative care team, a randomized controlled trial. J Palliat Med. 2008;11:80–90.
Temel J, Greer J, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363:733–42.
DiFrancesco V, Fantin F, Omizzolo F, et al. The anorexia of aging. Dig Dis. 2007;25:129–37.
Mitchell L. Clinical crossroads: a 93-year-old man with advanced dementia and eating problems. JAMA. 2007;298:2527–36.
Palecek EJ, Teno JM, Cararett DJ, et al. Comfort feeding only: a proposal to bring clarity to decision-making regarding difficulty with eating for persons with advanced dementia. J Am Geriatr Soc. 2010;58(3):580–4.
August D, Huhmann M. A.S.P.E.N. clinical guidelines: nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. J Parenter Enteral Nutr. 2009;33:472.
Casarett D, Kapo J, Caplan A. Appropriate use of artificial nutrition and hydration-fundamental principles and recommendations. N Engl J Med. 2005;353:2607–15.
Sampson E, Candy B, Jones L. Enteral tube feeding for older people with advanced dementia. Cochrane Database Syst Rev. 2009:CD007209.
Kurien M, McAlindon M, Westaby D, Sanders D. Percutaneous endoscopic gastrostomy (PEG) feeding. Br Med J. 2010; 340:c2414.
Gillick M, Volandes A. The standard of caring: why do we still use feeding tubes in patients with advanced dementia. J Am Med Dir Assoc. 2008;9:364–7.
Fordyce M. American geriatric society foundation for health and aging patient education forum: end of life care—a guide for patients and caregivers. 2011. http://www.healthinaging.org/public_education/pef/end_of_life_care.php. Accessed 12 Jan 2011.
McCann R, Hall W, Groth-Junker A. Comfort care for the terminally ill patient: the appropriate use of nutrition and hydration. JAMA. 1992;272:1263–6.
New York Department of Health. Medical Orders for Life-Sustaining Treatments. 2011. http://www.health.state.ny.us/professionals/patients/patient_rights/molst. Accessed 12 Jan 2011.
Morrison RS, Meier DE. Palliative Care. N Engl J Med. 2004;350:2582–90.
Murray SA, Kendall M, Boyd K, Sheikh A. Illness trajectories and palliative care. Br Med J. 2005;330(7498):1007–11.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Heath, J.M., Poplin, E. (2012). Palliative Care of GI Issues at the End of Life. In: Pitchumoni, C., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1623-5_64
Download citation
DOI: https://doi.org/10.1007/978-1-4419-1623-5_64
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4419-1622-8
Online ISBN: 978-1-4419-1623-5
eBook Packages: MedicineMedicine (R0)