Geriatric Palliative Care

Geriatric Palliative Care covers a broad spectrum of issues characterizing care near the end of life for older adults. Beginning with the social and cultural context of old age and frailty, this volume details specific aspects of palliative care relevant to particular disorders (e.g. cancer, strokes, dementia, etc.) as well as individual symptoms (e.g., pain, fatigue, anxiety, etc.). Communication between care-givers and patients, in a variety of settings, is also discussed.The theme of this book is that palliative care is the best approach to the care of chronically ill and frail elderly because of its focus on: quality of life; support for functional independence; and the centrality of the patient's values and experiences in determining the goals of medical care. Indeed, Geriatric Palliative Care provides a comprehensive medical reference for all clinicians who care for older adults.

PART I: OVERVIEW: THE SOCIAL AND CULTURAL CONTEXT OF OLD AGE AND FRAILTY; 1. Variability in End-of-Life Care in the United States; 2. Developmental Challenges and Opportunities for "Growth": The Inner Life at the End of Life; 3. Assessing Quality of Life and Quality of Dying in the Elderly: Implications for Clinical Practice of Palliative Medicine; 4. The Place of Love in the Care of Persons with Advanced Dementia; 5. Artifical Nutrition and Hydration; 6. Age, Rationing and Palliative Care; 7. Ethical Aspects of Geriatric Palliative Care; 8. Respecting Diversity; PART II: DISEASE- AND SYNDROME-SPECIFIC ASPECTS OF PALLIATIVE CARE; 9. Frailty and its Implications for Care; 10. Heart Disease; 11. Cancer; 12. Stroke: Prognosis, Treatment and Rehabilitation; 13. Dementia and Neurodegenerative Diseases; 14. Chronic Lung Disease and Lung Cancer; 15. End-Stage Renal Disease and Discontinuation of Dialysis; PART III: SYMPTOM DISTRESS IN OLDER PATIENTS; 16. Pain; 17. Dyspnea; 18. Gastrointestinal Symptoms; 19. Fatigue; 20. Delirium, Anxiety and Depression; PART IV: COMMUNICATION; 21. Advance Care Planning for Frail, Older Persons; 22. Doctor-Patient Communication; 23. Decision Making for the Cognitively Impaired; PART V: STRUCTURES OF CARE FOR THE CHRONICALLY ILL WITH PALLIATIVE CARE NEEDS; 24. Can We Make the Health-Care System Work?; 25. Palliative Care in the Nursing Home; 26. Family Caregivers: Burdens and Opportunities; 27. Home Care for Frail Older Adults; 28. Hospital-Based Palliative Care