Palliative Care Impacts Healthy Days for Older Adults

For seriously ill older adults, new research reveals a complex relationship between prognosis, cancer diagnosis, and healthy days spent at home, highlighting the need for tailored care approaches.

Study Highlights Prognosis Impact

A recent analysis of emergency department data from the NIH Collaboratory’s PRIM-ER trial showed that a poorer prognosis correlated with fewer healthy days at home for seriously ill older patients. Surprisingly, a cancer diagnosis was associated with an increase in healthy days at home.

Published in BMC Geriatrics, the analysis examined data from almost 123,000 older adults. The study also found that demographic factors such as age and race/ethnicity influenced healthy days at home.

PRIM-ER Trial Details

PRIM-ER, supported by the National Institute on Aging, was a cluster randomized trial evaluating a palliative care training program implemented within U.S. emergency departments. The program featured palliative care training, communication workshops using simulations, clinical decision support tools, and feedback mechanisms. More details about PRIM-ER can be found here.

Possible Explanations for Cancer Correlation

Oluwaseun Adeyemi of New York University, along with principal investigators Corita Grudzen and Keith Goldfeld, suggest that the increased healthy days at home for cancer patients may stem from “structured and comprehensive care pathways available to cancer patients, such as outpatient oncology services, home-based palliative care, and symptom management plans designed to minimize hospitalizations.”

Call for Tailored Care Models

The study underscores the importance of creating customized care models to improve patient outcomes. As the CDC reports, only 38% of adults aged 65 and older have discussed their end-of-life care preferences with a healthcare professional (CDC, 2023). Addressing this gap through enhanced outpatient and home-based services could significantly reduce hospitalizations and increase healthy days at home, especially for individuals with severe non-cancer illnesses, according to the authors.

The complete research article is available here.