Better Palliative Care for Older People

May 18, 2004
Most deaths in European and other developed countries occur in people aged over 65, but relatively little health policy concerns their needs in the last years of life. As life expectancy increases, the number of people living to older ages is also increasing in many countries. At the same time, the relaive number of people of working age is declining and he age of potential caregivers is increasing. Palliatve care is therefore of growing public health importance. Older people have traditionally received less palliative care than younger people and services have focused on cancer. This booklet is part of the WHO regional Office for Europe's work to present evidence for health policy - and decision-makers in a clear and understandable form. It presents the needs of older people, the different trajectories of illnesses they suffer, evidence of underassessment of pain and other symptoms, their need to be involved in decision-making, evidence for effecive palliative care solutions, and issues for the future.
  • In France, Germany, Italy, Japan and the UK. 4% of the population is over age 80.
  • Women are nearly twice as likely as men to live past age 80, and are more likely to suffer from several chronic conditions, such as dementia, osteoporosis, and arthritis.
  • International comparisons show no consistent relationship between the proportion of their GDP spent on healthcare for older people and proportion of elderly population.
  • One in three seriously ill patients who would prefer palliative or "comfort" care believe their medical care is at odds with their preference.
  • In the United States, studies have suggested that higher spending is not associated with higher quality care, better access to care, better health outcomes, or satisfaction with hospital care.
  • Older people have special palliative care needs because: they are more commonly affected by multiple medical problems of varying severity, or at greater risk of adverse drug reactions and iatrogenic illness, minor problems may have a greater cumulative psychological impact, and these illnesses may occur in conjunction with physical/mental impairment, economic hardship, and social isolation.
  • Older people have traditionally received less palliative care than younger people and services have focused on cancer.
  • Health professionals must ensure that older people with palliative care needs are regarded as individuals, that their right to make decisions about their health and social care is respected, and that they receive the unbiased information they need without experiencing discrimination because of their age.
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