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Vol 14, No 4 (2020)
Review paper
Published online: 2020-10-06
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Integrated palliative care and health care delivery among older adults

Helen Senderovich123, Maheen Mujtaba4, Danusha Vinoraj5
DOI: 10.5603/PMPI.2020.0026
·
Palliat Med Pract 2020;14(4):259-270.
Affiliations
  1. Baycrest Health Sciences, 3560 Bathurst Street, M6A 2E1 Toronto, Canada
  2. Department of Family and Community Medicine, University of Toronto, 500 University Ave, M5G 1V7 Toronto, Canada
  3. Division of Palliative Care, Faculty of Medicine, University of Toronto, 500 University Avenue, M5G 1V7 Toronto, Canada
  4. Department of Family and Community Medicine, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, V6T 1Z3 Vancouver, Canada
  5. Faculty of Medicine, University of Ottawa, 451 Smyth Rd #2044, K1H 8M5 Ottawa, Canada

open access

Vol 14, No 4 (2020)
Review paper
Published online: 2020-10-06

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.

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.

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Keywords

palliative care, delivery of healthcare, quality of life, chronic diseases, geriatric

About this article
Title

Integrated palliative care and health care delivery among older adults

Journal

Palliative Medicine in Practice

Issue

Vol 14, No 4 (2020)

Article type

Review paper

Pages

259-270

Published online

2020-10-06

Page views

3962322

Article views/downloads

526

DOI

10.5603/PMPI.2020.0026

Bibliographic record

Palliat Med Pract 2020;14(4):259-270.

Keywords

palliative care
delivery of healthcare
quality of life
chronic diseases
geriatric

Authors

Helen Senderovich
Maheen Mujtaba
Danusha Vinoraj

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