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Supportive and Palliative Approach to the Older Persons

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The Role of Family Physicians in Older People Care

Part of the book series: Practical Issues in Geriatrics ((PIG))

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Abstract

In the majority of high-income settings, palliative care (PC) still relies on hospital care and palliative care specialists, while the involvement of other healthcare professionals, notably general practitioners (GPs), is undefined and incomplete. Moreover, to develop the full potential of palliative care, the participation of the public is needed, from patients’ associations and caregivers to health advocacy associations and to national health systems.

For this to occur, the silent palliative care revolution must spread a palliative care culture among all stakeholders and participants in the care process.

Fear of death, stigmatization of patients and their relatives when facing a complex disease like cancer or organ failure, or dementia, leads to palliative care being similarly stigmatized, neglected, or unacceptable.

Early identification of patients for discussions of goals of care based on their needs and wishes is fundamental, keeping in mind that dying is a multidimensional process. GPs can play a pivotal role here, leading to improved quality of care and quality of life and in due course dying for both patients and caregivers.

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Notes

  1. 1.

    https://hospicecare.com/what-we-do/projects/consensus-based-definition-of-palliative-care/definition

References

  1. World Health Organization. Why palliative care is an essential function of primary health care. Geneva: World Health Organization; 2018.

    Google Scholar 

  2. Radbruch L, De Lima L, Knaul F, Wenk R, Ali Z, Bhatnaghar S, et al. Redefining palliative care–a new consensus-based definition. J Pain Symptom Manage. 2020;60(4):754–64.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Munday D, Boyd K, Jeba J, Kimani K, Moine S, Grant L, et al. Defining primary palliative care for universal health coverage. Lancet (London, England). 2019;394(10199):621.

    Article  Google Scholar 

  4. Scholten N, Günther AL, Pfaff H, Karbach U. The size of the population potentially in need of palliative care in Germany—an estimation based on death registration data. BMC Palliat Care. 2016;15(1):29.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Ferrell BR, Coyle N, Paice J. Oxford textbook of palliative nursing. Oxford: Oxford University Press; 2014.

    Google Scholar 

  6. Thomas K, Noble B. Improving the delivery of palliative care in general practice: an evaluation of the first phase of the Gold Standards Framework. Palliat Med. 2007;21(1):49–53.

    Article  PubMed  Google Scholar 

  7. Mahmood-Yousuf K, Munday D, King N, Dale J. Interprofessional relationships and communication in primary palliative care: impact of the Gold Standards Framework. Br J Gen Pract. 2008;58(549):256–63.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Banks I, Weller D, Ungan M, Selby P, Aapro M, Beishon M, et al. ECCO essential requirements for quality cancer care: primary care. Crit Rev Oncol Hematol. 2019;142:187–99.

    Article  PubMed  Google Scholar 

  9. Ranganathan A, Gunnarsson O, Casarett D. Palliative care and advance care planning for patients with advanced malignancies. Ann Palliat Med. 2014;3(3):144–9.

    PubMed  Google Scholar 

  10. Mitchell S, Tan A, Moine S, Dale J, Murray SA. Primary palliative care needs urgent attention. BMJ. 2019;365:l1827.

    Article  PubMed  Google Scholar 

  11. Murray SA, Mitchell S, Boyd K, Moine S. Palliative care: training the primary care workforce is more important than rebranding. BMJ. 2019;365:l4119.

    Article  PubMed  Google Scholar 

  12. Gómez-Batiste X, Martínez-Muñoz M, Blay C, Amblàs J, Vila L, Costa X, et al. Utility of the NECPAL CCOMS-ICO© tool and the Surprise Question as screening tools for early palliative care and to predict mortality in patients with advanced chronic conditions: a cohort study. Palliat Med. 2017;31(8):754–63.

    Article  PubMed  Google Scholar 

  13. Maas EAT, Murray SA, Engels Y, Campbell C. What tools are available to identify patients with palliative care needs in primary care: a systematic literature review and survey of European practice. BMJ Support Palliat Care. 2013;3(4):444–51.

    Article  PubMed  Google Scholar 

  14. Murray SA, Kendall M, Mitchell G, Moine S, Amblàs-Novellas J, Boyd K. Palliative care from diagnosis to death. BMJ. 2017;356:j878.

    Article  PubMed  Google Scholar 

  15. Fadul N, Elsayem A, Palmer JL, Del Fabbro E, Swint K, Li Z, et al. Supportive versus palliative care: what’s in a name? A survey of medical oncologists and midlevel providers at a comprehensive cancer center. Cancer. 2009;115(9):2013–21.

    Article  PubMed  Google Scholar 

  16. Meyers FJ, Linder J, Beckett L, Christensen S, Blais J, Gandara DR. Simultaneous care: a model approach to the perceived conflict between investigational therapy and palliative care. J Pain Symptom Manag. 2004;28(6):548–56.

    Article  Google Scholar 

  17. Greer JA, Pirl WF, Jackson VA, Muzikansky A, Lennes IT, Heist RS, et al. Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non–small-cell lung cancer. J Clin Oncol. 2012;30(4):394–400.

    Article  PubMed  Google Scholar 

  18. Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, et al. Early palliative care for patients with metastatic non–small-cell lung cancer. N Engl J Med. 2010;363(8):733–42.

    Article  CAS  PubMed  Google Scholar 

  19. Zimmermann C, Swami N, Krzyzanowska M, Hannon B, Leighl N, Oza A, et al. Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet. 2014;383(9930):1721–30.

    Article  PubMed  Google Scholar 

  20. Finucane AM, Bone AE, Evans CJ, Gomes B, Meade R, Higginson IJ, et al. The impact of population ageing on end-of-life care in Scotland: projections of place of death and recommendations for future service provision. BMC Palliat Care. 2019;18(1):1–11.

    Article  Google Scholar 

  21. Pattison M, Romer AL. Improving care through the end of life: launching a primary care clinic-based program. J Palliat Med. 2001;4(2):249–54.

    Article  CAS  PubMed  Google Scholar 

  22. Elliott M, Nicholson C. A qualitative study exploring use of the surprise question in the care of older people: perceptions of general practitioners and challenges for practice. BMJ Support Palliat Care. 2017;7(1):32–8.

    Article  PubMed  Google Scholar 

  23. Murray SA, Kendall M, Grant E, Boyd K, Barclay S, Sheikh A. Patterns of social, psychological, and spiritual decline toward the end of life in lung cancer and heart failure. J Pain Symptom Manag. 2007;34(4):393–402.

    Article  Google Scholar 

  24. Finucane AM, Davydaitis D, Horseman Z, Carduff E, Baughan P, Tapsfield J, et al. Electronic care coordination systems for people with advanced progressive illness: a mixed-methods evaluation in Scottish primary care. Br J Gen Pract. 2020;70(690):e20–e8.

    Article  PubMed  Google Scholar 

  25. Care WIP. Symptom relief into primary health Care: a WHO guide for planners, implementers and managers. Geneva: World Health Organization; 2018.

    Google Scholar 

  26. Russell BJ, Rowett D, Currow DC. Pro re nata prescribing in a population receiving palliative care: a prospective consecutive case note review. J Am Geriatr Soc. 2014;62(9):1736–40.

    Article  PubMed  Google Scholar 

  27. Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care. 1991;7(2):6–9.

    Article  CAS  PubMed  Google Scholar 

  28. Bruera E. The development of a palliative care culture. J Palliat Care. 2004;20(4):316–9.

    Article  PubMed  Google Scholar 

  29. Hui D, De La Cruz M, Mori M, Parsons HA, Kwon JH, Torres-Vigil I, et al. Concepts and definitions for “supportive care,” “best supportive care,” “palliative care,” and “hospice care” in the published literature, dictionaries, and textbooks. Support Care Cancer. 2013;21(3):659–85.

    Article  PubMed  Google Scholar 

  30. Kluge H, Kelley E, Swaminathan S, Yamamoto N, Fisseha S, Theodorakis PN, et al. After Astana: building the economic case for increased investment in primary health care. Lancet. 2018;392(10160):2147–52.

    Article  PubMed  Google Scholar 

  31. Barishansky RM. The silver tsunami: are you ready? America’s elderly population is exploding, and EMS services will have to reflect that. EMS World. 2016;45(8):53–6.

    PubMed  Google Scholar 

  32. Moore DC, Payne S, Van den Block L, ten Koppel M, Szczerbińska K, Froggatt K. Research, recruitment and observational data collection in care homes: lessons from the PACE study. BMC Res Notes. 2019;12(1):1–6.

    Article  Google Scholar 

  33. Arias N, Garralda E, Rhee JY, Lima L, Pons-Izquierdo JJ, Clark D, et al. EAPC Atlas of palliative care in Europe 2019. Vilvoorde: EAPC; 2019.

    Google Scholar 

  34. WHO, editor. Declaration of Astana. Global Conference on Primary Health Care; 2018.

    Google Scholar 

  35. Centeno C, Sitte T, De Lima L, Alsirafy S, Bruera E, Callaway M, et al. White paper for global palliative care advocacy: recommendations from a PAL-LIFE Expert Advisory Group of the Pontifical Academy for Life, Vatican City. J Palliat Med. 2018;21(10):1389–97.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Pettus K, Moine S, Kunirova G, De Lima L, Radbruch L. Palliative care comes of age in the 2018 declaration of Astana. J Palliat Med. 2019;22(3):242.

    Article  PubMed  Google Scholar 

  37. Bruera E, Anderson AE, Williams JL, Liu DD. A survey of palliative care clinicians’ weekly self-care practices. J Clin Oncol. 2019;37(31_suppl):59.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. AUSL, Modena, Italy

    Simone Cernesi

  2. Primary Care Department, USL Toscana Sud Est, Grosseto, Italy

    Jacopo Demurtas

  3. Unidad de Medicina Paliativa y Control de Síntomas, University of Navarra, Pamplona, Spain

    Carlos Centeno

  4. International Association for Hospice and Palliative Care, Houston, TX, USA

    Katherine Pettus

  5. Primary Palliative Care Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK

    Scott A. Murray

  6. Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Eduardo Bruera

Authors
  1. Simone Cernesi
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  2. Jacopo Demurtas
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  3. Carlos Centeno
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  4. Katherine Pettus
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  5. Scott A. Murray
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  6. Eduardo Bruera
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Corresponding author

Correspondence to Simone Cernesi .

Editor information

Editors and Affiliations

  1. Primary Care Department USL Toscana Sud Est, Grosseto, Italy

    Jacopo Demurtas

  2. Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy

    Nicola Veronese

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Cernesi, S., Demurtas, J., Centeno, C., Pettus, K., Murray, S.A., Bruera, E. (2022). Supportive and Palliative Approach to the Older Persons. In: Demurtas, J., Veronese, N. (eds) The Role of Family Physicians in Older People Care. Practical Issues in Geriatrics. Springer, Cham. https://doi.org/10.1007/978-3-030-78923-7_20

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  • DOI: https://doi.org/10.1007/978-3-030-78923-7_20

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-78922-0

  • Online ISBN: 978-3-030-78923-7

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