Palliative care for the oldest old: recommendations from the first Italian Consensus Conference

E.S. Zanetti 1-3, G.B. Guerrini 3 4, D. Chiesa 5, D. Bellandi 6, C. Bertelli 7, C. Carabellese 8, S. Di Meo 9, P. Lora Aprile 10, G.F. Massarelli 11, F. Nicoli 12 13, P. Ponton 14, S. Sperotto 9, G. Zaninetta 13 15, F. Lonati 2

1 University of Rome “Tor Vergata”, Rome, Italy; 2 APRiRE Network; 3 Italian Society of Gerontology and Geriatrics; 4 Brescia Solidale Foundation, Brescia, Italy; 5 Habilita Care & Research Hospital, Sarnico, Italy; 6 Fondazione Istituto Ospedaliero di Sospiro Onlus, Sospiro Italy; 7 Associazione Nazionale Tumori, Italy; Clinical Institute Città di Brescia, San Donato Group, Italy; 8 Fondazione Casa di Dio, Brescia, Italy, Extrahospital Geriatric Association, Italy; 9 Territorial Healthcare Agency Spedali Civili Brescia, Italy; 10 Italian College of General Practitioners and Primary Care, Florence, Italy; 11 Association “On the Other Side: Doctors, Nurses, Operators and Patients Together”; 12 Department of Biotechnology and Life Sciences, Center for Clinical Ethics, University of Insubria, Varese, Italy; 13 Domus Salutis Clinic, Teresa Camplani Foundation, Brescia, Italy; 14 Agency for health care N.3 “Alto Friuli - Collinare - Medio Friuli” - Gemona del Friuli, Italy; 15 Italian Palliative Care Society

In all care settings (hospital, health and social services facilities, and intermediate and home care), recognizing the need for palliative care for the oldest old – that is, when care and assistance for prevention, cure or rehabilitation purposes should aim at maximizing comfort and control of disturbing symptoms to safeguard the quality of life – is a challenging task.

The early identification, among the oldest old, of those who could benefit from palliative interventions has proved effective in improving their quality of life and that of their families, as well as in reducing costs and improving the appropriateness of interventions.

To answer this need, the non-profit APRIRE Association (Assistenza PRimaria In REte) – Health at km 0 – has promoted the Consensus Conference “Palliative care for the oldest old at home, in nursing homes and in hospices”. A Consensus Conference is one of the tools that allow achievement of an inter-party agreement on especially controversial and complex issues through a formal process; it favors the choice of directions for clinical practice that are as uniform as possible, and determines the means to provide patients with the best quality of care in relation to the available resources.

This consensus document was discussed and approved on October 24, 2018 in Rome by a panel of designated members of a number of scientific societies (Extrahospital Geriatric Association, Italian Association of Family and Community Nurses, Italian Association of Psychogeriatrics, Italian Palliative Care Society, Italian Society of Gerontology and Geriatrics, Italian College of General Practitioners and Primary Care, Italian Society of Geriatrics Hospital and Territory), the Department of Biotechnology and Life Sciences, Center for Clinical Ethics, University of Insubria, Varese, the National Federation of Physicians, Surgeons and Dentists, the National Federation of Nursing Professions, the National Council of the Order of Psychologists and the Italian National Institute of Health.

Download PDF