Palliative care in acute geriatric care units across Europe: Some reflections about the experience of geriatricians

PurposeLittle is known about geriatricians’ knowledge, training and attitudes towards end-of-life issues as well as about how their experience concerning end-of-life decisions in the older patient. The aim of this survey was to explore the experience and the attitudes of geriatricians across Europe towards end-of-life care of patients dying in acute geriatric care units.Subjects/Materials and methodsA quantitative online survey was sent to the 21 members of the full board of the European Union Geriatric Medicine Society (EUGMS). These representatives had the possibility to forward it to colleagues from their countries, if they were not working in a geriatric acute care unit.ResultsThirty-five geriatricians representing nine countries of Europe responded to the survey. The results highlighted a mortality rate in these units (between 10 and 30%). More than half of the geriatricians described few resources to help them deal with issues of end-of-life care (guidelines, ethics committee, and palliative care consultation). Twenty-four geriatricians had to take a decision to withhold or withdraw life-prolonging treatment in their patient. They reported a high level of burden associated with this decision-making and also the need of more training in palliative care.Discussion and conclusionThese results highlight a number of needs of geriatricians working in acute geriatric care units that should encourage an action plan on palliative care and geriatric medicine to improve the quality of life of older patients with chronic diseases and to avoid moral distress in caregivers.