Description
Elderly have less and later access to specialized palliative care services due to difficulties in palliative phase marking and identifying palliative care needs.Aim: To investigate differences and similarities of symptom prevalence and intensity of hospice patients in four different age-groups ≤65, 66–75, 76–85 and >85, to ameliorate the quality of and access to hospice care for patients of all ages.
Method: A cross-sectional study. Patients admitted from June 2007 to December 2014 to a high care hospice facility in the Netherlands, able and willing to self-assess symptom intensity within the first week after admission, enrolled in this study.
Prospectively collected data from the Utrecht Symptom Diary (USD), a Dutch adapted
translation of the Edmonton Symptom Assessment System, were used, measuring symptom intensity of 12 symptoms and well-being on a 0–10 numerical scale.
Outcomes: Symptom prevalence (USD>0) and symptom intensity.
Data analysis: Descriptive statistics, Chi
2, ANOVA and Kruskall Wallis. Significance: p< 0.05.
Results: A total of 227/342 (66.4%) patients were included: 38% men, median age 74 (31–96; SD 12.782). Ineligible patients were more likely to be >85, life expectancy <7 days, ECOG performance status=4 or survival<2 weeks.
Patients suffered from 6.3 symptoms concurrently, 4.6 scored >3 on USD. Fatigue, dry mouth and anorexia were most prevalent and intense in all age-groups, except for <65 in which pain was more prevalent then anorexia. Patients <65 suffered from pain more often (p=0.01)and intense (p=0.05), and patients >85 suffered from anorexia more often (p=0.47).
Conclusion: Little differences between age-groups, underpin the need for individualized hospice care for all patients despite age. However, old and severely ill patients were less able to self-assess their symptoms, indicating a need for innovative strategies to assess symptoms and specific needs of elderly by collaboration with geriatric and primary care specialists.
| Period | 10 May 2015 |
|---|---|
| Event title | EAPC 2015 14th World Congress of the European Association for Palliative Care: Building Bridges |
| Event type | Conference |
| Location | Copenhagen, DenmarkShow on map |
| Degree of Recognition | International |