Palliative care for older adults. A research collection

A collection of Age and Ageing journal papers focusing on palliative care for older adults

Population ageing is changing the landscape of palliative and end-of-life care. Increasingly, older people live with multimorbidity, frailty, dementia and functional decline over prolonged and uncertain illness trajectories. Their needs extend beyond symptom management to maintaining function, psychological, social and spiritual wellbeing, treatment decision-making and support for family caregivers. Yet much of modern palliative care developed around cancer and relatively predictable trajectories of deterioration. The challenge is how to organise care that responds to the complexity and uncertainty of serious illness in later life.

For this themed collection, we searched the Age and Ageing archives for research on palliative and end-of-life care published since January 2021. We identified 161 articles and selected 15 based on citation and download metrics and topic coverage. Together, these articles illustrate a field expanding beyond cancer and increasingly examining care needs, service models, intervention components, outcomes and costs. They are also suggestive of the next research priority—calibrating the appropriate response to identified palliative care needs i.e. right care for the right person and in the right setting.

Chetna Malhotra, Ellie B Andres

For those wishing to learn more about evidence palliative care for older adults we also offer this expert commentary: Palliative care for older adults: the right care, for the right person, in the right setting 

Dr Chetna Malhotra

Dr Ellie Andres

The collection

1. End-of-life care for older people: the way forward
2. Integrating community services provision for older people living with severe frailty: implications from an England-wide survey. 
3. The effectiveness of community-based palliative care programme components: a systematic review. 
4. Costs and cost-effectiveness of palliative care in residential aged care homes: a scoping review. 
5. Examining the role of specialist palliative care in geriatric care to inform collaborations: a survey on the knowledge, practice and attitudes of geriatricians in providing palliative care. 
6. What is the role of specialist palliative care in the management of home-based people dying from non-malignant conditions? 
7. Evaluating palliative care case conferences in primary care for patients with advanced non-malignant chronic conditions: a cluster-randomised controlled trial (KOPAL).
8. Experiences of family carers supporting older people within the last year of life in rural and remote areas in the UK. 
9. Strategies to improve end-of-life decision-making and palliative care following hip fracture in frail older adults: a scoping review.
10. Simultaneously reassuring and unsettling: a longitudinal qualitative study of community anticipatory medication prescribing for older patients.
11. Palliative care for older people with dementia—we need a paradigm shift in our approach. 
12. ‘I secretly wish. . .’ Caregivers’ expression of wish for death of persons with severe dementia.
13. The epidemiology of dying within 48 hours of presentation to emergency departments: a retrospective cohort study of older people across Australia and New Zealand. 
14. Patients’ preferred place of death: patients are willing to consider their preferences, but someone has to ask them. 
15. How social, psychological, and spiritual needs are supported in the last months of life: evidence from the English Longitudinal Study of Ageing end-of-life interviews.