Terminal care viewed from care-provider versus general population

Abstract

In an era of global aging, the care for the aged is one of the major societal concern. The comprehensive geriatric assessment (CGA) has proved to be a rational innovation to take care of the aged with impaired mental function and/or low activity of daily living. On the other hand, the reasonable attitude and philosophy for providing care for patients in terminal state is not settled. For example, there are least agreements on the terminal period, desirable place of death, living will of dementia patient, futile or under-therapy, and life support at death. In cancer patients, these problems have been practically resolved. Because there are many similarities between the management of elderly patients with CGA and that of patients with terminal state, CGA should be applied for all patients in terminal state with diseases besides malignancy. From the questionnaire to care-provider and general population, various opinions and many differences were observed between these two groups. Briefly, the opinions of care-provider were more reserved than that of general population. However, more than 70% of both groups were unanimous in that the present terminal care should be reformed. Otherwise, considering the diverse opinions for the terminal for the aged, serious discussions and suitable studies on terminal care are required for fulfilling rest of life and peaceful death of aged people.