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Palliative Care for Geriatric Psychiatric Patients with Life-Limiting Illness

  • Margaret W. Leung
  • Lawrence E. Kaplan
  • James A. Bourgeois
Chapter

Abstract

Many geriatric psychiatric patients face life-limiting illness. Optimal palliative care which focuses on aggressive symptom management while exploring advance care planning to help anticipate goals of care begins at the time of diagnosis of disease and continues until the end of life. Major neurocognitive disorder is discussed as a terminal illness that merits early palliative care involvement as physical complications are anticipated as part of the natural progression of disease. As life-limiting illness progresses, psychiatrists are often asked to weigh in the management of delirium, depressive, anxiety, and substance abuse disorders in the palliative care setting. Diagnostic and treatment challenges arise in managing these disorders because of medical frailty and the overlap of symptoms related to disease progression. Psychiatrists may also be asked to participate in evaluating patients who request physician aid in dying.

Keywords

Palliative care End-of-life care Prognosis Goals of care Major neurocognitive disorder Terminal delirium Depression Anxiety Substance use disorder Physician aid in dying 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Margaret W. Leung
    • 1
  • Lawrence E. Kaplan
    • 2
  • James A. Bourgeois
    • 3
  1. 1.Kaiser PermanenteRosevilleUSA
  2. 2.University of California San FranciscoSan FranciscoUSA
  3. 3.Baylor Scott and White Department of PsychiatryTexas A&M University College of MedicineTempleUSA

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