# Palliative Care for the Elderly With Heart Diseases in Tertiary Health care: A Concept Analysis

## TL;DR

This paper explores how palliative care can better support elderly patients with heart disease in tertiary healthcare settings.

## Contribution

The study provides a detailed concept analysis of palliative care for elderly cardiac patients in tertiary care.

## Key findings

- Palliative care for elderly cardiac patients involves symptom management, shared decision-making, and multidisciplinary approaches.
- Early integration of palliative care improves patient and family satisfaction and reduces hospital readmissions.
- Advanced Practice Nurses are vital in promoting palliative care for elderly heart failure patients.

## Abstract

The increasing incidence of heart failure (HF) in the elderly leads to increased mortality, hospitalization, length of hospital stay, and health care costs. Older adults often face multiple drug treatments, comorbidities, frailty, and cognitive problems, which require early palliative care. However, these patients do not receive adequate palliative care.

This concept analysis aimed to develop an in-depth understanding of palliative care for elderly patients with cardiac diseases in tertiary care.

The analysis was guided by Walker and Avant's method, and databases were searched using keywords, such as palliative care, tertiary care, elderly, and heart. Covidence was used to review the results using the inclusion and exclusion criteria.

The World Health Organisation’s definition of palliative care is widely accepted. Palliative care for older adults with heart disease in tertiary care is preceded by chronic illness, polypharmacy, symptom burden, physical and cognitive decline, comorbidities, and psychosocial/spiritual issues. The main attributes of palliative care for this population include health care professionals and patient education, holistic patient/family-centered care, symptom management, shared decision-making, early integration, advanced care planning, and a multidisciplinary approach. Palliative care improves elderly cardiac patients' and their family satisfaction while reducing readmission, hospital stays, and unnecessary invasive procedures.

Collaboration between hospitals, community organizations, transitional palliative care services, and research has the potential to improve early palliative care and the well-being of the elderly cardiac population. Advanced Practice Nurses (APNs) competencies play a crucial role in promoting palliative care in the elderly HF population.