Reimagining palliative care for older people living with frailty and multiple long-term conditions

Following her submissions to the Commission on Palliative and End of Life Care and Palliative Care Expert Panel, Caroline Nicholson, Professor of Palliative Care and Ageing at the University of Surrey, is calling for lawmakers to “reimagine” palliative care, particularly for our ageing population and those living with frailty and multiple long-term conditions (MLTCs).

Professor Nicholson and the Living and Dying Well team have published a series of resources, funded by the National Institute for Health and Care Research (NIHR), to support people who are involved in the care of older people living with Frailty and MLTCs.

We must reimagine palliative care and create a system that prioritises the needs of our ageing population and ensures that they receive the compassionate and comprehensive care they deserve.

We have identified significant gaps in the current palliative care system for older individuals with frailty and multiple long-term conditions. The present system often neglects the holistic needs of individuals who may live with their conditions for months or years before death.

Additionally, there is a lack of person-centred care, with older people’s voices and preferences frequently being overlooked. This leads to inadequate care plans and a significant burden on family and non-paid carers, who often lack sufficient support and training. Professor Caroline Nicholson, Professor of Palliative Care and Ageing

To address these challenges, Surrey’s team have proposed a series of policy recommendations, including:

Palliative care must become a service for all – progressive conditions such as Frailty require services to be integrated and attuned to palliative care , enabling tailored care across the period of illness.

Supporting families and unpaid carers, the “silent workforce”, to understand frailty, assess needs, and deliver person-centred care.

Creating a centralised point of entry for older people with complex care needs, ensuring coordinated and integrated care, which allows for compassionate conversations around end of life care.

Raising awareness about frailty, ageing and end-of-life care, empowering individuals and their families to make informed decisions and allowing for meaningful conversations to flourish.

Supporting the Centre for Ageing Better multi-organisation Call to Action to establish a Commissioner for Older People and Aging, as an independent champion for older people in England.

Incorporating the PALLUP toolkit and video for training with NHS trusts, to help raising awareness and shaping professional practice to the complexities of supporting older adults with frailty, emphasising the importance of person-centred care, communication, and shared decision-making.

By implementing these recommendations, policymakers can ensure older people live their final weeks, months or even years, with dignity and quality of life. Professor Caroline Nicholson, Professor of Palliative Care and Ageing

To learn more, visit: https://livinganddyingwellresearch.com/ 