South Texas Veterans Health Care System and the University of Texas Health Science Center at San Antonio Description

To evaluate if an inpatient geriatric palliative care consultation service influence symptom control, advance care planning, and subject-perceived quality of care.

Goal

To evaluate if a geriatric palliative care consultation service influence symptom control, advance care planning, and subject-perceived quality of care

Measures

Instruments included delirium (CAM), pain (scores) and function (ADL's)

Data Collected

Prospective case-control study of subjects seen by the geriatric palliative care consultation service (cases) and control group matched by age, gender, service of admission, and co-morbidity scores (validated instruments).

Summary of Results / What Worked and Why

N=110. 53 case-subjects and 57 control subjects. Subjects' mean age was 75. Ethnicity: 57% White, 42% Hispanic, 9% Black. 77% of subjects seen by geriatric palliative care consultation service completed Advance Directives vs. 47% not seen (P = 0.001). After consultation (intervention), 50% of case subjects had marked improvement of delirium (P <0.0001). 94% of case subjects had improved function (P <0.0001). 33% of case subjects had improvement in pain control (P <0.0001).

Our team concludes that a combined geriatric/palliative care consult service might be effective at improving symptom control, management of geriatric syndromes, and completion of Advance Directives. Significant results are seen in completion of advance directives, improvement in pain, management of geriatric syndromes (including delirium and functional status).