Volume 14 - Issue 10 - October, 2002
Chronic Wounds: Palliative Management for the Frail Population—PART I
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Introduction
The demographics of the American population are shifting dramatically toward a majority of persons over the age of 65. Currently, there are almost 34 million Americans aged 65 and over—almost 13 percent of all Americans. This number will grow to over 69 million (20% of all Americans) by the year 2030 and to almost 80 million by 2050. In contrast, the population under age 65 will increase only seven percent.1
Grass-roots caregiver groups all over the country are reporting more and more adult children taking on the responsibility for the care of their frail elderly p
Chronic Wounds: Palliative Management for the Frail Population—PART II
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Chronic Wounds in the Frail Population
This section will review specific wounds most often seen among frail elderly that may have gradually become recalcitrant and nonresponsive to treatment regimes.
Pressure ulcers. Definition. Of all the chronic wound categories included in this document, pressure ulcers have the least satisfactory definition, which may account for the broad application of this term to ulcers having different etiologic factors. The definition of a pressure ulcer, according to the Pressure Ulcers in Adults: Prediction and Prevention is “…any lesion ca
Chronic Wounds: Palliative Management for the Frail Population—Part III
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Compassionate Care Model for Patients with Nonhealing Chronic Wounds
Assessment. Palliative care principles address physical, psychological, social, spiritual, and practical objectives as well as individual patient needs. The primary goal of palliative management is to provide relief from suffering and to improve the quality of both the living and dying processes. The point at which palliative management goals eclipse curative treatment efforts must be established with each individual patient. The rigors demanded by available treatments, the longevity of illness, and the overall heal
Chronic Wounds: Palliative Management for the Frail Population—Part IV
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Patient-centered factors. Cognitive impairments: Depression, anxiety, and delirium. A frail elderly patient with a chronic nonhealing wound is likely to present with an extensive medical history that includes a wide range of medications, disturbances in sleep and activity patterns, episodes of medical set backs, and disease exacerbation. For these patients, it is common to find evidence of depression, anxiety, and some form of delirium. Additionally, it is important for clinicians to avoid making conclusions about the cause of delirium without adequate work up. It may be appropriate to
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