Multidimensional geriatric assessment is recommended as a standard of care for older adults with cancer. While there is often a very narrow focus on a new cancer diagnosis, the impact and influence of other factors makes cancer treatment in older population more challenging. It’s not just about cancer.
Geriatric syndromes such as falls, impaired cognition, depression, polypharmacy, and malnutrition are more common in frail patients. The development of geriatric syndromes reflects a patient’s reduced physiological reserve and vulnerability to stressors such as disease and illness. Frailty is the result of an accumulation of health-related issues across a range of geriatric domains. It has the potential to result in poor patient outcomes, complicate cancer treatment, reduce quality of life, and increase mortality risk, and increase burden to informal caregivers.
The Princess Alexandra Hospital employs a nurse-led geriatric model of care. Our group have previously demonstrated the validity of a Frailty Index (FI) derived from routine geriatric assessment domains. The FI conceptualizes frailty as a risk state which can be measured by the number, rather than the nature, of health-related issues. . The FI assessment provides a continuous measure of frailty, and it also highlights both vulnerabilities which may guide interventions, and strengths which inform resilience and reassure clinicians
While geriatrician-led comprehensive assessment (CGA) is considered the gold-standard for assessment and management of frail older adults, it is often not feasible in Australian cancer centre's. Nurses are ideally placed to assess older cancer patients, identify frailty, initiate interventions, and provide patient and care giver education. The PAH nurse-led model of geriatric oncology care provides frailty assessment for older adults (> 70 years) referred to medical oncology. This session highlights the benefits of this model of care, and provides examples of management of non-oncological issues, reminding us that it’s not just about cancer.