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Reducing the potential for suffering in older adults with advanced cancer

Published online by Cambridge University Press:  18 February 2010

Genevieve N. Thompson  and
Harvey M. Chochinov
Genevieve N. Thompson
Affiliation:
Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, Manitoba, Canada
Harvey M. Chochinov*
Affiliation:
Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, Manitoba, Canada Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
*
Address correspondence and reprint requests to: Harvey Chochinov, c/o CancerCare Manitoba, 3017-675 McDermot Avenue, Winnipeg, Manitoba, R3E 0V9, Canada. E-mail: harvey.chochinov@cancercare.mb.ca
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Abstract

Objective:

To deliver quality care at the end of life, understanding the impact of various changes and life transitions that occur in older age is essential. This review seeks to uncover potential sources of distress in an elder's physical, psychological, social, and spiritual well-being to shed light on the unique challenges and needs facing this age group.

Methods:

Papers relating to older adults (aged 65 years and older or a mean age of 65 years and older) with advanced/terminal cancer receiving palliative, hospice, or end-of-life care published after 1998 were reviewed.

Results:

Older adults with advanced cancer have unique needs related to changes in their physical, psychological, social, and spirituals well-being. Changes in each of these domains offer not only the risk of causing distress but also the potential for growth and development during the final stages of advanced cancer.

Significance of results:

Being aware of the various changes that occur with aging will help health care professionals tailor interventions to promote dignity-conserving care and greatly reduce the potential for suffering at the end of life.

Keywords

Older adultAdvanced cancerPalliative careDistressQuality of life

Information

Type
Review Article
Information
Palliative & Supportive Care , Volume 8 , Issue 1 , March 2010 , pp. 83 - 93
Copyright
Copyright © Cambridge University Press 2010

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References

REFERENCES

Aabom, B., Kragstrup, J., Vondeling, H., et al. (2005). Population-based study of place of death of patients with cancer: Implications for GPs. British Journal of General Practice, 55, 684–689.Google ScholarPubMed
Abraham, A., Kutner, J.S., & Beaty, B. (2006). Suffering at the end of life in the setting of low physical symptom distress. Journal of Palliative Medicine, 9, 658–665.CrossRefGoogle ScholarPubMed
Addington-Hall, J. & Altmann, D. (2000). Which terminally ill cancer patients in the United Kingdom receive care from community specialist palliative care nurses? Journal of Advanced Nursing, 32, 799–806.CrossRefGoogle ScholarPubMed
Addington-Hall, J., Altmann, D., & McCarthy, M. (1998). Variations by age in symptoms and dependency levels experienced by people in the last year of life, as reported by surviving family, friends and officials. Age and Ageing, 27, 129–136.CrossRefGoogle ScholarPubMed
Addington-Hall, J.M. & Karlsen, S. (1999). Age is not the crucial factor in determining how the palliative care needs of people who die from cancer differ from those of people who die from other causes. Journal of Palliative Care, 15, 13–19.CrossRefGoogle Scholar
Ahmad, S. & O'Mahony, M.S. (2007). Shift in the burden of cancer towards older people: A retrospective population-based study. International Journal of Clinical Practice, 61, 931–936.CrossRefGoogle ScholarPubMed
Ahmed, N., Bestall, J.C., Ahmedzai, S.H., et al. (2004). Systematic review of the problems and issues of accessing specialist palliative care by patients, carers and health and social care professionals. Palliative Medicine, 18, 525–542.CrossRefGoogle ScholarPubMed
Amella, E.J. (2003). Geriatrics and palliative care. Collaboration for quality of life until death. Journal of Hospice and Palliative Nursing, 5, 40–48.CrossRefGoogle Scholar
Andersson, M., Hallberg, I.R., & Edberg, A.K. (2008). Old people receiving municipal care, their experiences of what constitutes a good life in the last phase of life: A qualitative study. International Journal of Nursing Studies, 45, 818–828.CrossRefGoogle ScholarPubMed
Ando, M., Morita, T., & O'Connor, S.J. (2007). Primary concerns of advanced cancer patients identified through the structured life review process: A qualitative study using a text mining technique. Palliative & Supportive Care, 5, 265–271.CrossRefGoogle ScholarPubMed
Arnold, E.M., Artin, K.A., Griffith, D., et al. (2006). Unmet needs at the end of life: Perceptions of hospice social workers. Journal of Social Work in End-of-Life & Palliative Care, 2, 61–83.CrossRefGoogle ScholarPubMed
Arnold, E.M., Artin, K.A., Person, J.L., et al. (2004). Consideration of hastening death among hospice patients and their families. Journal of Pain and Symptom Management, 27, 523–532.CrossRefGoogle ScholarPubMed
Atchley, R.C. (2006). Continuity, spiritual growth, and coping in later adulthood. Journal of Religion, Spirituality & Aging, 18, 19–29.CrossRefGoogle Scholar
Bailey, C. & Corner, J. (2003). Care and the older person with cancer. European Journal of Cancer Care, 12, 176–182.CrossRefGoogle ScholarPubMed
Benzein, E., Norberg, A., & Saveman, B.I. (2001). The meaning of the lived experience of hope in patients with cancer in palliative home care. Palliative Medicine, 15, 117–126.CrossRefGoogle ScholarPubMed
Birrer, R.B. & Vemuri, S.P. (2004). Depression in later life: A diagnostic and therapeutic challenge. American Family Physician, 69, 2375–2382.Google ScholarPubMed
Blank, T.O. & Bellizzi, K.M. (2008). A gerontologic perspective on cancer and aging. Cancer, 112(11 Suppl), 2569–2576.CrossRefGoogle ScholarPubMed
Bolmsjo, I. (2000). Existential issues in palliative care: Interviews with cancer patients. Journal of Palliative Care, 16, 20–24.CrossRefGoogle ScholarPubMed
Breitbart, W., Rosenfeld, B., Pessin, H., et al. (2000). Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA, 284, 2907–2911.CrossRefGoogle ScholarPubMed
Burge, F., Johnston, G., Lawson, B., et al. (2002). Population-based trends in referral of the elderly to a comprehensive palliative care programme. Palliative Medicine, 16, 255–256.CrossRefGoogle ScholarPubMed
Calnan, M., Badcott, D., & Woolhead, G. (2006). Dignity under threat? A study of the experiences of older people in the United Kingdom. International Journal of Health Services, 36, 355–375.CrossRefGoogle ScholarPubMed
Cann, P. (2008). Pain in older adults should not be seen as part of ageing. British Journal of Community Nursing, 13, 574–576.CrossRefGoogle Scholar
Chen, H., Haley, W.E., Robinson, B.E., et al. (2003). Decisions for hospice care in patients with advanced cancer. Journal of the American Geriatrics Society, 51, 789–797.CrossRefGoogle ScholarPubMed
Chen, J.H., Chan, D.C., Kiely, D.K., et al. (2007). Terminal trajectories of functional decline in the long-term care setting. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 62, 531–536.CrossRefGoogle ScholarPubMed
Chochinov, H.M. (2002). Dignity-conserving care: A new model for palliative care: Helping the patient feel valued. JAMA, 287, 2253–2260.CrossRefGoogle Scholar
Chochinov, H.M. (2007). Dignity and the essence of medicine: The A, B, C, and D of dignity conserving care. British Medical Journal, 335, 184–187.CrossRefGoogle Scholar
Chochinov, H.M. & Cann, B.J. (2005). Interventions to enhance the spiritual aspects of dying. Journal of Palliative Medicine, 8(Suppl 1), s103–115.CrossRefGoogle ScholarPubMed
Chochinov, H.M., Hack, T., Hassard, T., et al. (2004). Dignity and psychotherapeutic considerations in end-of-life care. Journal of Palliative Care, 20, 134–142.CrossRefGoogle ScholarPubMed
Chochinov, H.M., Hack, T., McClement, S., et al. (2002). Dignity in the terminally ill: A developing empirical model. Social Science & Medicine, 54, 433–443.CrossRefGoogle ScholarPubMed
Chochinov, H.M., Wilson, K.G., Enns, M., et al. (1995). Desire for death in the terminally ill. The American Journal of Psychiatry, 152, 1185–1191.Google ScholarPubMed
Clayton, J.M., Butow, P.N., Arnold, R.M., et al. (2005). Fostering coping and nurturing hope when discussing the future with terminally ill cancer patients and their caregivers. Cancer, 103, 1965–1975.CrossRefGoogle ScholarPubMed
Closs, S.J., Chatwin, J., & Bennett, M.I. (2009). Cancer pain management at home (II): Does age influence attitudes towards pain and analgesia? Supportive Care in Cancer, 17, 781–786.CrossRefGoogle ScholarPubMed
Covinsky, K.E., Eng, C., Lui, L.Y., et al. (2003). The last 2 years of life: Functional trajectories of frail older people. Journal of the American Geriatrics Society, 51, 492–498.CrossRefGoogle ScholarPubMed
Cutillo-Schmitter, T.A. (1996). Aging: Broadening our view for improved nursing care. Journal of Gerontological Nursing, 22, 31–42.CrossRefGoogle ScholarPubMed
Davies, E. & Higginson, I. (2004). Better Palliative Care for Older People. Copenhagen, Denmark: World Health Organization Europe.Google Scholar
De Conno, F., Boffi, R., Brunelli, C., et al. (2002). Age-related differences in patients admitted to a palliative home care service. Tumori, 88, 117–122.CrossRefGoogle ScholarPubMed
Desbiens, N.A., Mueller-Rizner, N., Connors, A.F. Jr. et al. (1999). The symptom burden of seriously ill hospitalized patients. Journal of Pain and Symptom Management, 17, 248–255.CrossRefGoogle ScholarPubMed
Duggleby, W. (2000 a). Elderly hospice cancer patients' descriptions of their pain experiences. American Journal of Hospice & Palliative Care, 17, 111–117.CrossRefGoogle ScholarPubMed
Duggleby, W. (2000 b). Enduring suffering: A grounded theory analysis of the pain experience of elderly hospice patients with cancer. Oncology Nursing Forum, 27, 825–831.Google ScholarPubMed
Duggleby, W. & Raudonis, B.M. (2006). Dispelling myths about palliative care and older adults. Seminars in Oncology Nursing, 22, 58–64.CrossRefGoogle ScholarPubMed
Duggleby, W. & Wright, K. (2004). Elderly palliative care cancer patients' descriptions of hope-fostering strategies. International Journal of Palliative Nursing, 10, 352–359.CrossRefGoogle ScholarPubMed
Edmonds, P., Karlsen, S., Khan, S., et al. (2001). A comparison of the palliative care needs of patients dying from chronic respiratory diseases and lung cancer. Palliative Medicine, 15, 287–295.CrossRefGoogle ScholarPubMed
Elofsson, L.C. & Ohlen, J. (2004). Meanings of being old and living with chronic obstructive pulmonary disease. Palliative Medicine, 18, 611–618.CrossRefGoogle ScholarPubMed
Eriksson, M. & Andershed, B. (2008). Care dependence: A struggle toward moments of respite. Clinical Nursing Research, 17, 220–236.CrossRefGoogle ScholarPubMed
Fallowfield, L., Ratcliffe, D., Jenkins, V., et al. (2001). Psychiatric morbidity and its recognition by doctors in patients with cancer. British Journal of Cancer, 84, 1011–1015.CrossRefGoogle ScholarPubMed
Fehring, R.J., Miller, J.F., & Shaw, C. (1997). Spiritual well-being, religiosity, hope, depression, and other mood states in elderly people coping with cancer. Oncology Nursing Forum, 24, 663–671.Google ScholarPubMed
Ferrell, B.R. (1996). The quality of lives: 1,525 voices of cancer. Oncology Nursing Forum, 23, 909–916.Google ScholarPubMed
Ferrell, B.R. & Coyle, N. (2008). The Nature of Suffering and the Goals of Nursing. New York: Oxford University Press.CrossRefGoogle ScholarPubMed
Fitzsimons, D., Mullan, D., Wilson, J.S., et al. (2007). The challenge of patients' unmet palliative care needs in the final stages of chronic illness. Palliative Medicine, 21, 313–322.CrossRefGoogle ScholarPubMed
Franklin, L.L., Ternestedt, B.M., & Nordenfelt, L. (2006). Views on dignity of elderly nursing home residents. Nursing Ethics, 13, 130–146.CrossRefGoogle ScholarPubMed
Gagnon, B., Mayo, N.E., Hanley, J., et al. (2004). Pattern of care at the end of life: Does age make a difference in what happens to women with breast cancer? Journal of Clinical Oncology 22, 3458–3465.CrossRefGoogle ScholarPubMed
Garman, K.S. & Cohen, H.J. (2002). Functional status and the elderly cancer patient. Critical Reviews in Oncology/Hematology, 43, 191–208.CrossRefGoogle ScholarPubMed
Garstecki, D.C. & Erler, S.F. (2001). Personal and social conditions potentially influencing women's hearing loss management. American Journal of Audiology, 10, 78–90.CrossRefGoogle ScholarPubMed
Gibson, S.J., & Helme, R.D. (2001). Age-related differences in pain perception and report. Clinics in Geriatric Medicine, 17, 433–456, v–vi.CrossRefGoogle ScholarPubMed
Giddings, L.S., Roy, D.E., & Predeger, E. (2007). Women's experience of ageing with a chronic condition. Journal of Advanced Nursing, 58, 557–565.CrossRefGoogle ScholarPubMed
Gilbar, O., Or Han, K., & Plivazky, N. (2005). Mental adjustment, coping strategies, and psychological distress among end-stage renal disease patients. Journal of Psychosomatic Research, 58, 471–476.CrossRefGoogle ScholarPubMed
Goldstein, N.E. & Morrison, R.S. (2005). The intersection between geriatrics and palliative care: A call for a new research agenda. Journal of the American Geriatrics Society, 53, 1593–1598.CrossRefGoogle Scholar
Grande, G.E., McKerral, A., Addington-Hall, J.M., et al. (2003). Place of death and use of health services in the last year of life. Journal of Palliative Care, 19, 263–270.CrossRefGoogle ScholarPubMed
Gruneir, A., Smith, T.F., Hirdes, J., et al. (2005). Depression in patients with advanced illness: An examination of Ontario complex continuing care using the minimum data set 2.0. Palliative & Supportive Care, 3, 99–105.CrossRefGoogle ScholarPubMed
Hall, S., Gallagher, R.M., Gracely, E., et al. (2003). The terminal cancer patient: Effects of age, gender, and primary tumor site on opioid dose. Pain Medicine, 4, 125–134.CrossRefGoogle ScholarPubMed
Hallberg, I.R. (2004). Death and dying from old people's point of view. A literature review. Aging Clinical and Experimental Research, 16, 87–103.CrossRefGoogle ScholarPubMed
Hallberg, I.R. (2006). Palliative care as a framework for older people's long-term care. International Journal of Palliative Nursing, 12, 224–229.CrossRefGoogle ScholarPubMed
Hansson, R.O., Hayslip, B., & Stroebe, M.S. (2007). Grief and bereavement. In Handbook of Gerontology: Evidence-Based Approaches to Theory, Practice, and policy, Blackburn, J.A. & Dulmus, C.N. (eds.), pp. 367–394. Hoboken, NJ: John Wiley & Sons, Inc.CrossRefGoogle Scholar
Hermann, C.P. (2001). Spiritual needs of dying patients: A qualitative study. Oncology Nursing Forum, 28, 67–72.Google ScholarPubMed
Hermann, C.P. (2007). The degree to which spiritual needs of patients near the end of life are met. Oncology Nursing Forum, 34, 70–78.CrossRefGoogle ScholarPubMed
Herth, K. (1990). Fostering hope in terminally-ill people. Journal of Advanced Nursing, 15, 1250–1259.CrossRefGoogle ScholarPubMed
Jackson, J.M., Rolnick, S.J., Coughlin, S.S., et al. (2007). Social support among women who died of ovarian cancer. Supportive Care in Cancer, 15, 547–556.CrossRefGoogle ScholarPubMed
Johnson, S. (2007). Hope in terminal illness: An evolutionary concept analysis. International Journal of Palliative Nursing, 13, 451–459.CrossRefGoogle ScholarPubMed
Kafetz, K. (2002). What happens when elderly people die? Journal of the Royal Society of Medicine, 95, 536–538.CrossRefGoogle ScholarPubMed
Kane, R.A. (1991). Psychosocial issues. Psychological and social issues for older people with cancer. Cancer, 68(11 Suppl), 2514–2518.3.0.CO;2-D>CrossRefGoogle ScholarPubMed
Keating, N.L., Landrum, M.B., Guadagnoli, E., et al. (2008). Care in the months before death and hospice enrollment among older women with advanced breast cancer. Journal of General Internal Medicine, 23, 11–18.CrossRefGoogle ScholarPubMed
Kelly, B., McClement, S., & Chochinov, H.M. (2006). Measurement of psychological distress in palliative care. Palliative Medicine, 20, 779–789.CrossRefGoogle ScholarPubMed
King, D.A., Heisel, M.J., & Lyness, J.M. (2005). Assessment and psychological treatment of depression in older adults with terminal or life-threatening illness. Clinical Psychology, 12, 339–353.Google Scholar
Kramer, S.E., Kapteyn, T.S., Kuik, D.J., et al. (2002). The association of hearing impairment and chronic diseases with psychosocial health status in older age. Journal of Aging and Health, 14, 122–137.CrossRefGoogle ScholarPubMed
Krause, N. (2007). Longitudinal study of social support and meaning in life. Psychology and Aging, 22, 456–469.CrossRefGoogle ScholarPubMed
Kronenfeld, J.J. (2006). Changing conceptions of health and life course concepts. Health, 10, 501–517.CrossRefGoogle ScholarPubMed
Kurtz, M.E., Kurtz, J.C., Stommel, M., et al. (2002). Predictors of depressive symptomatology of geriatric patients with lung cancer: A longitudinal analysis. Psycho-Oncology, 11, 12–22.CrossRefGoogle ScholarPubMed
Kutner, J.S., Bryant, L.L., Beaty, B.L., et al. (2007). Time course and characteristics of symptom distress and quality of life at the end of life. Journal of Pain and Symptom Management, 34, 227–236.CrossRefGoogle ScholarPubMed
Lackan, N.A., Freeman, J.L., & Goodwin, J.S. (2003). Hospice use by older women dying with breast cancer between 1991 and 1996. Journal of Palliative Care, 19, 49–53.CrossRefGoogle ScholarPubMed
Ley, D.C. (1989). The elderly and palliative care. Journal of Palliative Care, 5, 43–45.CrossRefGoogle ScholarPubMed
Lin, H.R. & Bauer-Wu, S.M. (2003). Psycho-spiritual well-being in patients with advanced cancer: An integrative review of the literature. Journal of Advanced Nursing, 44, 69–80.CrossRefGoogle ScholarPubMed
Liu, J. & Matulonis, U. (2006). End-of-life care. In Treatment and Management of Cancer in the Elderly, Muss, H.B., Hunter, C.P., & Johnson, K.A. (eds.), pp. 559–586. New York: Taylor & Francis.Google Scholar
Lloyd-Williams, M., Dennis, M., & Taylor, F. (2004). A prospective study to determine the association between physical symptoms and depression in patients with advanced cancer. Palliative Medicine, 18, 558–563.CrossRefGoogle ScholarPubMed
Lundh Hagelin, C., Seiger, A., & Furst, C.J. (2006). Quality of life in terminal care: With special reference to age, gender and marital status. Supportive Care in Cancer, 14, 320–328.CrossRefGoogle ScholarPubMed
Lunney, J.R., Lynn, J., Foley, D.J., et al. (2003). Patterns of functional decline at the end of life. JAMA, 289, 2387–2392.CrossRefGoogle ScholarPubMed
Lyness, J.M. (2004). End-of-life care: Issues relevant to the geriatric psychiatrist. The American Journal of Geriatric Psychiatry, 12, 457–472.CrossRefGoogle Scholar
Mackey, K.M. & Sparling, J.W. (2000). Experiences of older women with cancer receiving hospice care: Significance for physical therapy. Physical Therapy, 80, 459–468.CrossRefGoogle ScholarPubMed
MacKinlay, E. (2006). Spiritual care: Recognizing spiritual needs of older adults. Journal of Religion, Spirituality & Aging, 18, 59–71.CrossRefGoogle Scholar
Madnawat, A.V. & Kachhawa, P.S. (2007). Age, gender, and living circumstances: Discriminating older adults on death anxiety. Death Studies, 31, 763–769.CrossRefGoogle ScholarPubMed
Mako, C., Galek, K., & Poppito, S.R. (2006). Spiritual pain among patients with advanced cancer in palliative care. Journal of Palliative Medicine, 9, 1106–1113.CrossRefGoogle ScholarPubMed
Matzo, M.L. & Sherman, D.W. (eds.). (2004). Gerontologic Palliative Care Nursing. St. Louis: Mosby.Google Scholar
McClain, C.S., Rosenfeld, B., & Breitbart, W. (2003). Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. Lancet, 361, 1603–1607.CrossRefGoogle ScholarPubMed
McClement, S.E., Chochinov, H.M., Hack, T.F., et al. (2004). Dignity-conserving care: Application of research findings to practice. International Journal of Palliative Nursing, 10, 173–179.CrossRefGoogle ScholarPubMed
Miller, J.F. (2007). Hope: A construct central to nursing. Nursing Forum, 42, 12–19.CrossRefGoogle Scholar
Miller, M., Mogun, H., Azrael, D., et al. (2008). Cancer and the risk of suicide in older americans. Journal of Clinical Oncology, 26, 4720–4724.CrossRefGoogle ScholarPubMed
Morasso, G., Capelli, M., Viterbori, P., et al. (1999). Psychological and symptom distress in terminal cancer patients with met and unmet needs. Journal of Pain and Symptom Management, 17, 402–409.CrossRefGoogle ScholarPubMed
Morita, T., Tsunoda, J., Inoue, S., et al. (1999). Contributing factors to physical symptoms in terminally-ill cancer patients. Journal of Pain and Symptom Management, 18, 338–346.CrossRefGoogle ScholarPubMed
Morrison, R.S., & Meier, D.E. (eds.). (2003). Geriatric Palliative Care. New York: Oxford University Press.Google Scholar
Nelson, C.J., Rosenfeld, B., Breitbart, W., & Galietta, M. (2002). Spirituality, religion, and depression in the terminally ill. Psychosomatics, 43, 213–220.CrossRefGoogle ScholarPubMed
Nussbaum, J.F., Baringer, O., & Kundrat, A. (2003). Health, communication, and aging: Cancer and older adults. Health Communication, 15, 185–192.CrossRefGoogle ScholarPubMed
Osse, B.H., Vernooij-Dassen, M.J., Schade, E., et al. (2005). The problems experienced by patients with cancer and their needs for palliative care. Supportive Care in Cancer, 13, 722–732.CrossRefGoogle ScholarPubMed
Pautex, S., Berger, A., Chatelain, C., Herrmann, F., & Zulian, G. B. (2003). Symptom assessment in elderly cancer patients receiving palliative care. Critical Reviews in Oncology/Hematology, 47, 281–286.CrossRefGoogle ScholarPubMed
Payne, D.K. & Massie, M.J. (2000). Anxiety in palliative care. In Handbook of Psychiatry in Palliative Medicine, Chochinov, H.M. & Breitbart, W. (eds.), pp. 63–74. New York: Oxford University Press.Google Scholar
Peters, L. & Sellick, K. (2006). Quality of life of cancer patients receiving inpatient and home-based palliative care. Journal of Advanced Nursing, 53, 524–533.CrossRefGoogle ScholarPubMed
Riechelmann, R.P., Krzyzanowska, M.K., O'Carroll, A., et al. (2007). Symptom and medication profiles among cancer patients attending a palliative care clinic. Supportive Care in Cancer, 15, 1407–1412.CrossRefGoogle ScholarPubMed
Rolnick, S.J., Jackson, J., Nelson, W.W., et al. (2007). Pain management in the last six months of life among women who died of ovarian cancer. Journal of Pain and Symptom Management, 33, 24–31.CrossRefGoogle ScholarPubMed
Rose, J.H., Radziewicz, R., Bowmans, K.F., et al. (2008). A coping and communication support intervention tailored to older patients diagnosed with late-stage cancer. Clinical Interventions in Aging, 3, 77–95.CrossRefGoogle ScholarPubMed
Rosenwax, L.K. & McNamara, B.A. (2006). Who receives specialist palliative care in Western Australia: And who misses out. Palliative Medicine, 20, 439–445.CrossRefGoogle ScholarPubMed
Roth, A.J. (2008). Understanding depression in the elderly cancer patient. journal of Supportive Oncology, 6, 84–86.Google Scholar
Rovner, B.W., Zisselman, P.M., & Shmuely-Dulitzki, Y. (1996). Depression and disability in older people with impaired vision: A follow-up study. Journal of the American Geriatrics Society, 44, 181–184.CrossRefGoogle ScholarPubMed
Rozzini, R., Frisoni, G.B., Ferrucci, L., et al. (2002). Geriatric index of comorbidity: Validation and comparison with other measures of comorbidity. Age and Ageing, 31, 277–285.CrossRefGoogle ScholarPubMed
Russac, R.J., Gatliff, C., Reece, M., et al. (2007). Death anxiety across the adult years: An examination of age and gender effects. Death Studies, 31, 549–561.CrossRefGoogle ScholarPubMed
Sand, L., Strang, P., & Milberg, A. (2008). Dying cancer patients' experiences of powerlessness and helplessness. Supportive Care in Cancer, 16, 853–862.CrossRefGoogle ScholarPubMed
Seeman, T.E. (2000). Health promoting effects of friends and family on health outcomes in older adults. American Journal of Health Promotion, 14, 362–370.CrossRefGoogle ScholarPubMed
Shaw, B.A., Krause, N., Liang, J., et al. (2007). Tracking changes in social relations throughout late life. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 62, S90–99.CrossRefGoogle ScholarPubMed
Shugarman, L.R., Bird, C.E., Schuster, C.R., et al. (2007). Age and gender differences in Medicare expenditures at the end of life for colorectal cancer decedents. Journal of Women's Health, 16, 214–227.CrossRefGoogle ScholarPubMed
Smith, A.W., Reeve, B.B., Bellizzi, K.M., et al. (2008). Cancer, comorbidities, and health-related quality of life of older adults. Health Care Financing Review, 29, 41–56.Google ScholarPubMed
Sparks, L. & Nussbaum, J.F. (2008). Health literacy and cancer communication with older adults. Patient Education and Counseling, 71, 345–350.CrossRefGoogle ScholarPubMed
Spoletini, I., Gianni, W., Repetto, L., et al. (2008). Depression and cancer: An unexplored and unresolved emergent issue in elderly patients. Critical Reviews in Oncology/Hematology, 65, 143–155.CrossRefGoogle ScholarPubMed
Stillion, J.M. (2006). Understanding the end of life: An overview. In Psychosocial Issues Near the End of Life, Werth, J. L. & Blevins, D. (eds.), pp. 11–26. Washington, DC: American Psychological Association.Google Scholar
Strang, P. (1998). Cancer pain: A provoker of emotional, social and existential distress. Acta Oncologica, 37, 641–644.CrossRefGoogle ScholarPubMed
Strassels, S.A., Blough, D.K., Hazlet, T.K., et al. (2006). Pain, demographics, and clinical characteristics in persons who received hospice care in the United States. Journal of Pain and Symptom Management, 32, 519–531.CrossRefGoogle ScholarPubMed
Street, D.A. (2007). Sociological approaches to understanding age and aging. In Handbook of gerontology. evidence-based approaches to theory, practice, and policy, Blackburn, J.A. & Dulmus, C.N. (eds.), pp. 143–168. Hoboken: NJ: John Wiley & Sons, Inc.CrossRefGoogle Scholar
Teunissen, S.C., de Haes, H.C., Voest, E.E., et al. (2006). Does age matter in palliative care? Critical Reviews in Oncology/Hematology, 60, 152–158.CrossRefGoogle ScholarPubMed
Thome, B., Dykes, A.K., & Hallberg, I.R. (2004). Quality of life in old people with and without cancer. Quality of Life Research, 13, 1067–1080.CrossRefGoogle ScholarPubMed
Thompson, G.N. & Chochinov, H.M. (2009). Palliative care: Special considerations for older adults with cancer. In Geriatric Oncology: Treatment, Assessment and Management Hurria, A. & Balducci, L. (eds.), pp. 293–324. Dordrecht, the Netherlands: Springer.CrossRefGoogle Scholar
Tornstam, L. (1996). Caring for the elderly. Introducing the theory of gerotranscendence as a supplementary frame of reference for caring for the elderly. Scandinavian Journal of Caring Sciences, 10, 144–150.CrossRefGoogle ScholarPubMed
Turner, N.J., Haward, R.A., Mulley, G.P., et al. (1999). Cancer in old age: Is it inadequately investigated and treated? British Medical Journal, 319, 309–312.CrossRefGoogle ScholarPubMed
Unger, J.B., McAvay, G., Bruce, M.L., et al. (1999). Variation in the impact of social network characteristics on physical functioning in elderly persons. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 54, S245–251.CrossRefGoogle ScholarPubMed
Veach, T.A. & Nicholas, D.R. (1998). Understanding families of adults with cancer: Combining the clinical course of cancer and stages of family development. Journal of Counseling and Development, 76, 144–156.CrossRefGoogle Scholar
White, H.K., & Cohen, H.J. (2008). The older cancer patient. Nursing Clinics of North America, 43, 307–222, vii.CrossRefGoogle ScholarPubMed
Wijk, H. & Grimby, A. (2008). Needs of elderly patients in palliative care. American Journal of Hospice & Palliative Care, 25, 106–111.CrossRefGoogle ScholarPubMed
Wilson, K.G., Chochinov, H.M., McPherson, C.J., et al. (2007 a). Suffering with advanced cancer. Journal of Clinical Oncology, 25, 1691–1697.CrossRefGoogle ScholarPubMed
Wilson, K.G., Chochinov, H.M., Skirko, M.G., et al. (2007 b). Depression and anxiety disorders in palliative cancer care. Journal of Pain and Symptom Management, 33, 118–129.CrossRefGoogle ScholarPubMed
Yan, S. & Kin-Fong, C. (2006). Quality of life of patients with terminal cancer receiving palliative home care. Journal of Palliative Care, 22, 261–266.CrossRefGoogle ScholarPubMed
Zaza, C. & Baine, N. (2002). Cancer pain and psychosocial factors: A critical review of the literature. Journal of Pain and Symptom Management, 24, 526–542.CrossRefGoogle ScholarPubMed