ABSTRACT
Palliative care in the elderly appropriately takes place within a spectrum of curative, rehabilitative, preventive, and chronic disease management interventions, and seeks to optimize quality of life. Setting priorities among numerous legitimate treatment goals is the central task in the care of chronically ill frail individuals. Decision-making can be challenging when the goal of providing comfort comes into conflict with the goal of prolonging life, and should be guided whenever possible by consistently expressed preferences of the patient. The assessment and relief of distressing physical and psychological symptoms should receive active attention at all stages in the care of the frail elderly, both in the context of acute medical and surgical interventions and during the terminal phase of life. Pain and dyspnea are frequently reported by significant proportions of elderly individuals hospitalized for chronic lung disease, heart failure, and cirrhosis as well as for malignancies. In the treatment of dementia, the types of interventions that improve quality of life will differ in the early and late phases of the illness.
Subject(s)
Frail Elderly , Palliative Care/methods , Quality of Life/psychology , Terminal Care/methods , Aged , Aged, 80 and over , Chronic Disease/psychology , Dementia/psychology , Humans , Palliative Care/psychology , Terminal Care/psychologyABSTRACT
The authors report a case of focal myocardial necrosis, presenting clinically as an acute myocardial infarction during the administration of the antineoplastic drug, amsacrine, in a patient without coronary artery disease. In addition to the recognized arrhythmic complications, the authors emphasize myocardial necrosis as a possible further manifestation of amsacrine-related cardiotoxicity.
