Update in geriatrics: What geriatric oncology can learn from general geriatric research

'I decided to attend to him because it's my duty': Student Nurses perception and attitude towards care of older adults

BACKGROUND AND AIM

Nurses perception and attitude towards an older patient can positively or negatively influence the quality rendered. As students under training, the views of this population needs to be sought and shaped to improve the quality of care the older patients receive. This is because life expectancy is on the rise. The study aimed to explore students' perception of ageing and their attitude towards care of the older adults.

METHODS AND MATERIALS

An exploratory descriptive design was used. Data form containing the sociodemographic attributes of the students and a semi-structured interview form developed by the researchers in line with the literature. The participants interviewed were student nurses who had been in clinical practice for at least one semester. Four focus group discussions (FGD) were held.

RESULTS

Average age of the participants was 22.30 years. An equal number of males and females (15 each) were recruited to have a balance in gender. Students expressed that they saw the older adults as their grandparents so they try to accord them respect and care. However, older adults are perceived not receptive to nurses in training. The students stated that registered nurses neglected the basic care of older adults such as diaper changes, bathing, and feeding, and would rather beckon student nurses to attend to the older adults.

CONCLUSION

Gerontology as a stand-alone course is necessary for early years of training to give an in-depth education to nursing students and instil a positive attitude towards older adult patients.

Older adults with cancer and their caregivers - current landscape and future directions for clinical care

Despite substantial improvements in the outcomes of patients with cancer over the past two decades, older adults (aged ≥65 years) with cancer are a rapidly increasing population and continue to have worse outcomes than their younger counterparts. Managing cancer in this population can be challenging because of competing health and ageing-related conditions that can influence treatment decision-making and affect outcomes. Geriatric screening tools and comprehensive geriatric assessment can help to identify patients who are most at risk of poor outcomes from cancer treatment and to better allocate treatment for these patients. The use of evidence-based management strategies to optimize geriatric conditions can improve communication and satisfaction between physicians, patients and caregivers as well as clinical outcomes in this population. Clinical trials are currently underway to further determine the effect of geriatric assessment combined with management interventions on cancer outcomes as well as the predictive value of geriatric assessment in the context of treatment with contemporary systemic therapies such as immunotherapies and targeted therapies. In this Review, we summarize the unique challenges of treating older adults with cancer and describe the current guidelines as well as investigational studies underway to improve the outcomes of these patients.

Supporting older adults with chemotherapy treatment: A mixed methods exploration of cancer caregivers' experiences and outcomes

PURPOSE

Due to delivery of chemotherapy being mostly in ambulatory care settings, support of people with cancer relies heavily on caregivers (e.g. relatives). Whilst cancer caregiver research has been flourishing, there has been little focus on the specific experiences of caregivers of older people (>70yrs) with cancer, and little considerations of cultural influences on their experiences. This study explored caregiver experiences and outcomes in the geriatric oncology context in Switzerland.

METHODS

Sequential mixed-methods design, comprising a) cross-sectional survey (n = 86/RR52%; age range 37-85) and b) interviews (n = 19) to explore experiences of caregivers of older people (mean age in yrs 74.6 (sd 4.3) with cancer, and factors related to caregivers' psychological morbidity and health related quality of life (HrQoL).

RESULTS

Caregivers reported a median of three moderate/high unmet needs (range 0-41) and 44% reported clinically significant psychological morbidity. Demographics (caregiver age, gender, and marital status), caregiving tasks (physical, psycho-emotional, social and/or treatment related care), unmet needs and caregiver burden collectively explained between 20 and 57% of variance in caregiver psychological morbidity and HRQoL. Two main themes emerged from interviews: "Being a caregiver and doing caregiving" and "Living through the situation." These indicated that caregiver roles are multiple and fluid, and identified responsibilities not previously reported outside of palliative care settings, such as thinking about and planning for death and dying.

CONCLUSIONS

Caregiving for an older person with cancer can have detrimental impacts on caregivers' wellbeing and quality of life. Consideration needs to be given to the particular needs of caregivers in geriatric oncology settings. Their support needs appear different to those of their counterparts caring for younger people with cancer, notably related to spiritual needs; this may in part relate to possible differences arising from caregivers themselves being older.

Barriers to Hospice and Palliative Care Research: A Patient-Centered Approach to Intervention Studies

Overcoming barriers in hospice and palliative care research is a multifaceted challenge for researchers conducting intervention studies. The complexity and variations of these barriers are abundant and serious in nature and can threaten the success of intervention research for the hospice and palliative care patient population. This article explores how challenges and barriers to intervention research can be mitigated by nurses caring for patients in hospice and palliative care settings.

Epidemiological Profile of Patients of Aged 65 Years and Over in a University Private Hospital

Objectives

An increase in life expectancy is predicted for the general population and, by 2050, about one billion people will be older than 65 years. The Global Cancer Incidence, Mortality and Prevalence database estimates that 1.2 million people of this age will have cancer; this number represents 58% of new cases in the American population. This represents a challenge for diagnosis and treatment, given that some older people have multiple comorbidities and disabilities.

Materials and Methods

This was a retrospective descriptive study of 204 patients aged 65 years and over. All had a solid tumor that was diagnosed in a private hospital from January 2015 to December 2017.

Results

The median age was 72.2 years; the most frequent age group (48.5% of patients) was 65–75 years, and only a small percentage (4.4%) were aged > 85 years. The most common type of cancer was lung cancer (22.5%), followed by colorectal and urinary cancer. Most patients received cancer treatment after the disease diagnosis.

Conclusion

There are no epidemiological studies of the older oncology population in Mexico. We believe it is necessary to perform larger studies to understand this population and to undertake actions to facilitate greater attention to patient diagnosis, treatment, and alleviation.