Cancer-Specific Geriatric Assessment and Survivorship Care
Cancer-Specific Geriatric Assessment and Survivorship Care
Older adults constitute the greatest percentage of cancer survivors in the country, with 61% being aged 65 years and older. Assessing older adult cancer survivors beyond chronological age to include changes in functional status is an essential process to help nurses anticipate cancer treatment impact and aid in planning individualized survivorship care. The objective of this article is to identify a method to assess older adult cancer survivors to be used in tailoring survivorship care. A review of geriatric literature was conducted through MEDLINE® and PubMed from 1997–2011 and focused on the pathophysiology of aging, cancer impact, and comorbidities in this population. Results were combined with previous research to provide an evidence-based approach to assessing older cancer survivors. The resulting assessment provides valuable information on the functional status of older adult patients with cancer. This assessment can be used by nurses to develop treatment plans and tailor management strategies to improve quality of life.
The population of the United States is aging, with about 36.8 million adults aged 65 years and older. That number is projected to rise to 70–75 million by 2030 (National Cancer Institute, 2007). The current size and expected increase of this population mean that the healthcare needs of older adults will create challenges for healthcare systems. When considering healthcare needs along with the cancer-related needs of the population, the scope of those challenges becomes even greater.
Older adults constitute the greatest percentage of cancer survivors in the United States, with 61% of cancer survivors being aged 65 years and older (Bellizzi, Mustian, Palesh, & Diefenbach, 2008; Rowland, 2008). A cancer survivor refers to the individual diagnosed with cancer, throughout the trajectory of their life, as well as their families and caregivers (Hewitt, Greenfield, & Stovall, 2006). The need for excellent cancer survivorship care has become apparent and is highlighted in Hewitt et al. (2006).
Cancer survivorship care for this growing population involves combining the expected late and long-term effects of cancer and cancer treatment with information about expected changes in health status that occur with aging. Individuals at a specific chronological age vary in functionality, cognition, and the ability to handle stress (Walston et al., 2006). Although chronological age is the first component that starts the assessment process, additional tools are needed to understand an individual's functional age and to tailor survivorship care to the needs of an individual. A variety of factors other than chronological age can identify older adults who are at risk of morbidity and mortality. These factors, which may be captured in a geriatric assessment, include functional status, comorbidities, cognition, psychological state, social support, and nutritional status (Hurria et al., 2005; Yancik, 1997). The purpose of this article is to describe a method to assess older adults with cancer prior to or at the beginning of cancer treatment to provide nurses with information to better anticipate care needs throughout treatment and survivorship.
Abstract and Introduction
Abstract
Older adults constitute the greatest percentage of cancer survivors in the country, with 61% being aged 65 years and older. Assessing older adult cancer survivors beyond chronological age to include changes in functional status is an essential process to help nurses anticipate cancer treatment impact and aid in planning individualized survivorship care. The objective of this article is to identify a method to assess older adult cancer survivors to be used in tailoring survivorship care. A review of geriatric literature was conducted through MEDLINE® and PubMed from 1997–2011 and focused on the pathophysiology of aging, cancer impact, and comorbidities in this population. Results were combined with previous research to provide an evidence-based approach to assessing older cancer survivors. The resulting assessment provides valuable information on the functional status of older adult patients with cancer. This assessment can be used by nurses to develop treatment plans and tailor management strategies to improve quality of life.
Introduction
The population of the United States is aging, with about 36.8 million adults aged 65 years and older. That number is projected to rise to 70–75 million by 2030 (National Cancer Institute, 2007). The current size and expected increase of this population mean that the healthcare needs of older adults will create challenges for healthcare systems. When considering healthcare needs along with the cancer-related needs of the population, the scope of those challenges becomes even greater.
Older adults constitute the greatest percentage of cancer survivors in the United States, with 61% of cancer survivors being aged 65 years and older (Bellizzi, Mustian, Palesh, & Diefenbach, 2008; Rowland, 2008). A cancer survivor refers to the individual diagnosed with cancer, throughout the trajectory of their life, as well as their families and caregivers (Hewitt, Greenfield, & Stovall, 2006). The need for excellent cancer survivorship care has become apparent and is highlighted in Hewitt et al. (2006).
Cancer survivorship care for this growing population involves combining the expected late and long-term effects of cancer and cancer treatment with information about expected changes in health status that occur with aging. Individuals at a specific chronological age vary in functionality, cognition, and the ability to handle stress (Walston et al., 2006). Although chronological age is the first component that starts the assessment process, additional tools are needed to understand an individual's functional age and to tailor survivorship care to the needs of an individual. A variety of factors other than chronological age can identify older adults who are at risk of morbidity and mortality. These factors, which may be captured in a geriatric assessment, include functional status, comorbidities, cognition, psychological state, social support, and nutritional status (Hurria et al., 2005; Yancik, 1997). The purpose of this article is to describe a method to assess older adults with cancer prior to or at the beginning of cancer treatment to provide nurses with information to better anticipate care needs throughout treatment and survivorship.