Inpatient care for elderly cancer patients: the role for Geriatric Evaluation and Management Units in fulfilling goals for care.

PURPOSE: To describe patterns of functional status, symptoms, therapeutic goals and outcomes among older adults with cancer diagnoses hospitalized on a Geriatric Evaluation and Management Unit (GEMU). DESIGN AND METHODS: Retrospective chart review of veterans with a cancer diagnosis consecutively admitted to a Department of Veterans Affairs GEMU between 1996 and 1999. RESULTS: Thirty-six veterans with cancer diagnoses, average age of 80+/-5.0 years, 100% men, 50% white, 39% married were admitted during the target period. Comorbid illness was common (mean +/- S.D. = 4.6+/-2.0) as were associated symptoms (mean = 2.5+/-1.9). Average Karnofsky performance status was 55+/-7. Goals were accomplished 78% of the time for diagnosis, 73% for symptom management, 79% for functional improvement, and 100% for disposition/caregiver support. IMPLICATIONS: Elderly oncology patients admitted to a GEMU display diverse needs and goals that are realistic and attainable in this context. In-patient GEMU services represent a promising approach to care for older cancer patients, and deserve further evaluation of benefits and risks.

Duke Scholars

Author Eleanor Schildwachter McConnell School of Nursing

Author Harvey Jay Cohen Medicine, Geriatrics and Palliative Care

Author Katherine Schuver Garman Medicine, Gastroenterology