The treatment of terminally ill geriatric patients

A retrospective study was carried out on 150 patients who died in assessment and long stay wards in a geriatric unit to assess problems during their terminal illness. Thirty-two per cent of the long stay and 41 % of the assessment patients were considered to have been distressed during the last week of their life. Agitation was the commonest form of distress. Patients with a respiratory diagnosis were particularly distressed as were those with pulmonary oedema, suggesting that breathing problems are more difficult to manage. No concern was recorded as being expressed by relatives about the treatment patients received but eight relatives were distressed within the last week of the patient's life. A raised urea was more often found in distressed patients. Opiates were used in 56% of all patients but in low doses (2.5-5 mgs diamorphine orally 4-hourly) in the majority. More attention to comfort is requtred for those who are dehydrated and distressed in terminal care.