ABSTRACT
LGBTQ+ patients encounter discrimination and bias in health care settings. They experience worse health outcomes than their cisgender and heterosexual counterparts. There are numerous ways to provide equitable and comprehensive palliative care to seriously ill LGBTQ+ individuals. These strategies include communication techniques, encouragement to complete advance directives, implicit bias training, and interdisciplinary collaboration.
Subject(s)
Sexual and Gender Minorities , Transgender Persons , Female , Humans , Aged , Palliative Care , Comprehensive Health CareABSTRACT
Global palliative medicine is a priority for global health. The aging world population lives with multiple chronic diseases and malignancies that often lead to debility, morbidity, mortality, and decreased quality of life. In the United States, 68% of adults aged older than 65 years live with 2 or more chronic conditions. Endeavors to improve access to palliative care for seniors are ongoing within "age-friendly health systems." This review article aims to provide an overview of the present state of global geriatric palliative care and to identify potential areas for future improvement.
Subject(s)
Palliative Care , Quality of Life , Humans , Aged , AgingABSTRACT
CONTEXT: LGBTQ+ people and their families have unique needs, concerns, and issues when navigating serious illness. OBJECTIVES: To develop curricular milestones and an educational framework for hospice and palliative medicine (HPM) fellowship programs to meet the needs of this community. METHODS: A working group has developed a plan for the inclusion of LGBTQ+ competencies in HPM fellowship programs, utilizing input from an AAHPM Special Interest Group (SIG) at a national meeting. DISCUSSION: Learning to provide culturally competent care is essential for all HPM providers. Our group recommends specific clinical training competencies with plans to pilot them in upcoming academic years. Creating curricular recommendations will help guide fellowship programs education in the care of LGBTQ+ patients with serious illness.
Subject(s)
Hospices , Palliative Medicine , Sexual and Gender Minorities , Humans , Palliative Medicine/education , Fellowships and Scholarships , Education, Medical, Graduate , Palliative CareABSTRACT
Elderly patients who are critically ill have unique challenges that must be considered when attempting to prognosticate survival and determine expectations for physical rehabilitation and meaningful recovery. Furthermore, frail elderly patients present unique rehabilitation and clinical challenges when suffering from critical illness. There are multiple symptoms and syndromes that affect morbidity and mortality of elderly patients who require intensive care unit management including delirium, dementia, pain, and constipation. Rehabilitation goals should be based on patient values, clinical course, and functional status. Patients and families need accurate prognostic information to choose the appropriate level of care needed after critical illness.
