Aligning care with geriatric psychiatry patients’ end-of-life goals

What are the goals of care for older adults receiving geriatric psychiatric care? And how well are the patients’ personal preferences reflected in their treatment plans? A new study shows that there is a gap between the goals of care and patients’ personal wishes, suggesting a need for more person-centered care in geriatric psychiatry.

The study, published in the Journal of Aging Research, was based on a descriptive qualitative content analysis of medical records of patients enrolled at an outpatient clinic for geriatric psychiatry at the time of death. This was also complemented by a basic quantitative analysis of patient characteristics. A total of 66 medical records of patients were included in the study, with a mean age of 83 years ranging from 66 to 104 years. 41 precent of the patients were male, 59 precent were female. Most of the patients were diagnosed with depression.

The authors found that while the medical records often focused on managing the patients' illnesses or symptoms, they did not clearly reflect the patients' personal wishes or end-of-life goals. In fact, the patients' goals seemed to focus more on well-being and comfort, rather than just recovery from illness.

“Patient wishes documented in medical records reveal goals other than remission, including outspoken existential needs,” says Niklas Juth, Professor of Medical Ethics, Research Leader at the Centre for Research Ethics & Bioethics at Uppsala University, and co-author of the study.

According to the authors, there is a need to discuss how person-centered goals of care can be formulated in geriatric psychiatry. Addressing this gap may not only improve the quality of care for older adults, but also ensure that their final years are spent in accordance with their values and preferences.

Do you want to know more? Read the article: Kullenberg, Helena, Helgesson, Gert, Juth, Niklas, Lindblad, Anna, Psychiatric Goals of Care at the End of Life: A Qualitative Analysis of Medical Records at a Geriatric Psychiatric Outpatient Clinic, Journal of Aging Research, 2024, 2104985, 10 pages, 2024. DOI: 10.1155/jare/2104985

By Fanny Klingvall