Role of Palliative Care in Improving the Quality of Life in Elderly with Advanced Lung Disease

The traditional “either cure or comfort” approach does not optimize palliative care in elderly with advanced lung disease. Instead, a holistic, patient-centered, “comfort and cure together” approach with palliative and best care practices integrated as needed across the entire illness course will improve quality of life and other outcomes in these patients and their families. Competency in primary palliative care, identification of patient and family vulnerability, care plans formed by patient-centered communication, timely palliative responsiveness, and effective advance care planning are key components that support this approach. Dependency of patients on emergency or in-patient care for crisis of dyspnea and other symptoms is costly. To resolve this issue, a proactive, collaborative management with appropriate and carefully monitored use of opioids and other treatment is recommended. A revised primary care—integrating palliative care to curative/restorative care and judiciously referring to specialist palliative care—is essential for sustainable improvement in palliative care delivery.