Palliative care for older people - World Health Organization ...

1IntroductionPalliative care is an important public health issuedue to population ageing, the increasing numberof older people in most societies and insufficientattention to their complex needs. Palliative carefocuses on improving the symptoms, dignity andquality of life of people approaching the end oftheir lives and on the care of and support for theirfamilies and friends. This topic is often neglected,although it is relevant to everybody. In the past,palliative care was mostly offered to people withcancer in hospice settings. It must now be offeredmore widely and integrated more broadly acrosshealth care services.Although most deaths occur among people whoare older, there is relatively little policy concerningtheir specific needs towards the end of life.Populations worldwide are ageing, leading to adramatic increase in the numbers of people livinginto their seventies, eighties and nineties. Patternsof disease in the last years of life are also changing,with more people dying from chronic debilitatingconditions, such as cardiovascular disease, chronicobstructive pulmonary disease, diabetes, cancerand dementia. Since many of these illnesses oftenoccur together among older people, this groupfrequently experiences multiple health problemsand disabilities. In the last year of life, they havesymptoms such as pain, anorexia, low mood, mentalconfusion, constipation, insomnia and problemswith bladder and bowel control (1). Palliative careservices urgently need to be developed to meetthe complex needs of older people. These servicesneed to be available for people with diseases otherthan cancer and offered based on need rather thandiagnosis or prognosis.This publication is the third of a series publishedby WHO that aims to raise awareness of the needfor better palliative care.The first publication in the series, Palliative care– the solid facts (2), builds a comprehensive pictureof the complex nature of palliative care, describingkey trends and principles and discussing their policyimplications.The second publication, Better palliative care forolder people (3), focuses on the special needs ofolder people and the major public health challengethey represent. It provides evidence that the needs“All people have a right to receive high-qualitycare during serious illness and to a dignifieddeath free from overwhelming pain and in linewith their spiritual and religious needs.”Palliative care – the solid facts (2)1