Integrated palliative care and health care delivery among older adults

Abstract

Background: Improving end-of-life care (EOL) is increasingly recognized as a health priority, and inadequate integration of palliative care (PC) services globally represents a serious gap in healthcare while serving an aged population. Objective: This review aims to understand how an integrated approach to PC may be influential in the delivery of health care amongst an aged population. Methods: A scoping review was conducted in which 15 randomized controlled trials (RCT) discussing integrated and traditional PC, published between 2000 and July 2020 were included. RCTs were identified and thematically analysed using the framework described by Arksey and O’Malley. Results: The themes identified discuss the effect of early integration of PC on improving patient’s quality of life (QoL), cost-effectiveness, the importance of coordinated care between healthcare professionals, and stigma attached to PC. The early integration of PC has been shown to significantly improve the QoL of elderly patients with advanced cancer and/or chronic medical conditions. A reduction in unnecessary hospitalizations, shortened overall hospital stay, decreased stay in an intensive care unit (ICU), along with decreased caregiver burden has also been shown in studies. Conclusion: Effective coordination of care is crucial in the prevention of fragmented care and in ensuring the expressed wishes of patients are honoured. Furthermore, the stigma attached to the provision of PC is largely due to inadequate knowledge about PC and hence, education is key.