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“Progressive dwindling” or “terminal decline” and end of life care

Ravindrarajah, Rathi ; Gulliford, Martin

BMJ (Online), 2017-10, Vol.359, p.j4772-j4772 [Periódico revisado por pares]

England: BMJ Publishing Group LTD

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  • Título:
    “Progressive dwindling” or “terminal decline” and end of life care
  • Autor: Ravindrarajah, Rathi ; Gulliford, Martin
  • Assuntos: Aging ; Electronic health records ; Electronic medical records ; Frailty ; Health risk assessment ; Hospice Care ; Humans ; Older people ; Palliative Care ; Terminal Care
  • É parte de: BMJ (Online), 2017-10, Vol.359, p.j4772-j4772
  • Notas: SourceType-Other Sources-1
    content type line 63
    ObjectType-Correspondence-1
    ObjectType-Commentary-2
  • Descrição: Oliver discusses some of the difficulties faced by geriatricians responsible for the care of frail older people. 1 Accumulating evidence shows that a key aspect of the frailty syndrome is its relation to adverse outcomes, including hospital admissions, falls, fractures, and death. 2 3 4 5 Oliver uses the term progressive dwindling to refer to the progressive and accelerating functional decline that may occur at the end of life in very old people. Other writers have referred to this process as terminal decline or terminal drop. 6 Empirical evidence of terminal decline has been reported for cognitive functioning 7 and subjective health measures. 8 Our recent study using electronic health records in people aged 80 years and over showed a substantial terminal decline in blood pressure in the final two years of life that was not observed in patients who did not die. 9 Diehr and colleagues found that changes in health due to ageing are difficult to distinguish from those related to dying. 8 Researchers and clinicians should aim to determine whether these processes are distinguishable to improve end of life care for older people.
  • Editor: England: BMJ Publishing Group LTD
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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