Palliative care for older adults

OVERVIEW In modern industrialized societies, the experience of death is often preceded by lengthy illness. This chapter therefore commences with a study of palliative care and key aspects, including pain and symptom management and advance care planning. It proceeds to examine caregiver burden and settings of care before a final section on grief and bereavement. Introduction Any textbook on gerontology would not be complete without a chapter on the topic of death, dying and bereavement. Indeed, that was the intended title of this section of the book. However, a brief discussion of the context in which many older adults live today, and eventually die, will help explain the alternative title as it appears above. In 1900, the leading causes of death in the USA were pneumonia, tuberculosis and intestinal infections. This pattern was true across much of the developed world. These three diseases are all infectious, all resulted in rapid death due to lack of effective treatments, and all affected individuals of all ages. With modern advances, first in sanitation and later in antibiotics and other medical treatments, some people with these ailments survived and others were prevented from contracting the illnesses in the first place. One of the consequences of these advances is what Robert Butler (2008) has coined the longevity revolution.