RESUMO
Objetivo: analizar la bibliografía existente respecto a los conocimientos, habilidades y actitudes que estas disciplinas pueden aportar en la mejora de la calidad técnica, ética y humana de la asistencia sanitaria a ancianos con enfermedad avanzada, multimorbilidad, fragilidad y demencia progresiva. Material y métodos: revisión exhaustiva, focalizando en la bibliografía existente sobre la interrelación entre la medicina geriátrica y la medicina paliativa, la educación en bioética, herramientas pronósticas, el estado funcional y la humanización de la asistencia. Resultados: la planificación anticipada de las decisiones, la valoración geriátrica integral, el estudio de los valores del paciente y su inclusión en la toma de decisiones y la necesidad de promover una ética de la virtud, del cuidado y de la organización sanitaria constituyen elementos esenciales para conseguir dicho objetivo. Conclusiones: los profesionales y las organizaciones sanitarias deben aspirar a la excelencia como una exigencia moral. Para ello es prioritario adquirir virtudes de cuidado y conceptos fundamentales de medicina geriátrica y medicina paliativa, constituyendo el estado funcional, la planificación anticipada de los cuidados y el abordaje de las necesidades del binomio paciente-familia cuestiones irrenunciables que hay que proteger, cuidar y promover
Objective: to analyze the literature as regards the knowledge, skills and attitudes that these disciplines can provide in improving technical, ethical and human quality health care in the elderly with advanced organ failure, multimorbidity, frailty and progressive dementia. Material and methods: a comprehensive review focused on available references on the interrelationship between geriatric medicine and palliative medicine, education in bioethics, prognostic tools, functional status, and the humanization of health care. Results: advance care planning, comprehensive geriatric assessment, the study of the values of the patient and their introduction in decision-making process, as well as the need to promote moral, care, and healthcare organizational ethics, are essential elements to achieve this objective. Conclusions: practitioners and healthcare organizations should seek excellence as a moral requirement. To achieve this, there is a priority to acquire virtues of care and fundamental concepts of geriatric and palliative medicine, assessing functional status, advance care planning and patient/family needs as essential issues to protect, care for and promote them in all care settings
Assuntos
Humanos , Idoso , Bioética , Geriatria , Medicina Paliativa , Planejamento Antecipado de Cuidados , Avaliação Geriátrica , Escores de Disfunção OrgânicaRESUMO
OBJECTIVE: To analyze the literature as regards the knowledge, skills and attitudes that these disciplines can provide in improving technical, ethical and human quality health care in the elderly with advanced organ failure, multimorbidity, frailty and progressive dementia. MATERIAL AND METHODS: A comprehensive review focused on available references on the interrelationship between geriatric medicine and palliative medicine, education in bioethics, prognostic tools, functional status, and the humanization of health care. RESULTS: Advance care planning, comprehensive geriatric assessment, the study of the values of the patient and their introduction in decision-making process, as well as the need to promote moral, care, and healthcare organizational ethics, are essential elements to achieve this objective. CONCLUSIONS: Practitioners and healthcare organizations should seek excellence as a moral requirement. To achieve this, there is a priority to acquire virtues of care and fundamental concepts of geriatric and palliative medicine, assessing functional status, advance care planning and patient/family needs as essential issues to protect, care for and promote them in all care settings.
