Geriatric Palliative Care

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Overview

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.

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Editorial Reviews

Doody's Review Service
Reviewer: David O. Staats, MD (University of Oklahoma Health Sciences Center)
Description: This multiauthored book attempts to combine geriatric medicine and palliative medicine.
Purpose: The purpose is to assist physicians to reframe and broaden medical care of older persons to provide the right care in the right place at the right time for older persons. These are worthy objectives, as the population is increasingly aged, and since most deaths occur in older persons. This is an interesting first pass attempt at a synthesis.
Audience: The authors probably indicate this book is for attending physicians. I think it could be read by ethicists, students of geriatrics, and learners of palliative care. The authors are all recognized leaders in the field.
Features: Outstanding chapters in this book are those on variability of end-of-life care in the U.S. and making the healthcare system work. The former brilliantly analyzes the regional differences in end-of-life care as a function of the distribution of medical manpower and other healthcare resources, implying economic underpinnings of decision making. It also analyzes these differences as a function of the world view of the populations served. The latter chapter is an invitation to build a better mousetrap — how we, as a society, can use knowledge acquired in this area to create better policies and implementation based on better ways of thinking about the delivery of end-of-life care to an aging population. The chapter on communication with older persons at the end of life is also noteworthy. Some of the other chapters presume a knowledge of both geriatrics and palliative care that may not be there; others are too superficial for persons with a knowledge of one or the other areas.
Assessment: For trainees on a typical rotation, the American College of Physicians publication Physician's Guide to End-of-Life Care (2001) can be swallowed whole in the time allotted; this cannot. For trainees in either discipline, the extant textbooks of geriatrics and palliative medicine clearly give greater depth than this work. For a first pass at combing the two approaches, this is not bad.

3 Stars from Doody
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Product Details

  • ISBN-13: 9780195141917
  • Publisher: Oxford University Press, USA
  • Publication date: 5/28/2003
  • Pages: 464
  • Product dimensions: 10.10 (w) x 7.10 (h) x 1.20 (d)

Meet the Author

Both at Hertzberg Palliative Care Institute, Brookdale Department of Geriatrics and Adult Development

Weill Medical College of Cornell University, NY

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Table of Contents

Section 1 Overview: The Social & Cultural Context of Old Age & Frailty
1. Variability in End-of-Life Care in the United States, John E. Wennberg, MD, MPH, and Susan W. Tolle, MD
2. Developmental Challenges and Opportunities for "Growth": The Inner Life at the End of Life, Robert N. Butler
3. Assessing Quality of Life and Quality of Dying in the Elderly: Implications for Clinical Practice of Palliative Medicine, J. Randall Curtis, MD, MPH, and Donald L. Patrick, PhD, MSPH
4. The Place of Love in the Care of Persons with Advanced Dementia, Stephen G. Post
5. Artificial Nutrition and Hydration, Colleen Christmas, MD and Tom Finucane, MD
6. Age, Rationing, and Palliative Care, Daniel Callahan, PhD, and Eva Topinkova, MD, PhD
7. Ethical Aspects of Geriatric Palliative Care, Linda Emanuel, MD, PhD, Madelyn A. Iris, PhD, and James R. Webster, MS, MD
8. Respecting Diversity in Geriatric Palliative Care, Marion Danis, MD, and Risa Lavizzo-Mourey, MD
Disease and Syndrome-Specific Aspects of Palliative Care
9. Frailty and its Implication for Care, Jeremy D. Walston, MD, and Linda P. Fried, MD, MPH
10. Heart Disease, Julia M. Addington-Hall, PhD, honMFPHM, Angie Rogers, MSc, Anne McCoy, MSc, J. Simon R. Gibbs, MD, FRCP
11. Cancer, Natalie R. Sacks, MD, and Janet L. Abrahm, MD
12. Stroke: Prognosis, Treatment, and Rehabilitation, Steven R. Flanagan, MD and Stanley Tuhrim, MD
13. Dementia and Neuro-Degenerative Diseases, Ellen Olson, MD
14. Chronic Lung Disease and Lung Cancer, John P. Kremarik, MD, Thomas J. Predergast, MD, E. Wesley Ely, MD, and James R. Runo, MD
15. End Stage Renal Disease and Discontinuation of Dialysis, Lewis M. Cohen, MD, Michael Germain, MD, and Maura Brennan, MD
Symtom Distress in Older Patients
16. Pain, Bruce A. Ferrell, MD and Elizabeth Whiteman, MD
17. Dyspnea, Cynthia X. Pan, MD
18. Gastrointestinal Syptoms, Nigel P. Sykes, MA, BM, BCh, FRCGP
19. Fatigue, Deborah Witt Sherman, PhD, RN, ANP, CS and Marianne LaPorte Matzo, PhD, RN, GNP, CS
20. Delirium, Anxiety, and Depression, Elizabeth Goy, PhD, and Linda Ganzini, MD
Communication
21. Advance Care Planning for Frail, Older Persons, Joan M. Teno, MD, MS
22. Doctor-Patient Communication, James A. Tulsky, MD
23. Decision-Making for the Cognitively Impaired, Timothy E. Quill, MD and Robert McCann, MD
Structures of Care for the Chronically Ill with Palliative Care Needs
24. Can We Make the Health-Care System Work?, Janice Lynch, MFA, Sarah Myers, MPH, Susan K. Rogers, MS, BSN,CHPN, Susan Emmer, Esq., and Joanne Lynn, MD
25. Palliative Care in the Nursing Home, John M. Carter, MD and Eileen Chichin, PhD
26. Family Caregivers: Burdens and Opportunities, Carol Levine, MA
27. Home Care for Frail Older Adults, Knight Steel, MD and Caroline Vitale, MD
28. Hospital-Based Palliative Care, Daniel Fischberg, MD and Diane Meier, MD

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