Scope of treatment and clinical-decision making in the older patient with COVID-19 infection, a European perspective.

Purpose: Older patients were particularly vulnerable to severe COVID-19 disease resulting in high in-hospital mortality rates during the two first waves. The aims of this study were to better characterize the management of older people presenting with COVID-19 in European hospitals and to identify national guidelines on hospital admission and ICU admission for this population.

Methods: Online survey based on a vignette of a frail older patient with Covid-19 distributed by e-mail to all members of the European Geriatric Medicine Society.

Consensus document and recommendations on palliative care in heart failure of the Heart Failure and Geriatric Cardiology Working Groups of the Spanish Society of Cardiology.

Heart failure is a complex entity, with high morbidity and mortality. The clinical course and outcome are uncertain and difficult to predict. This document, instigated by the Heart Failure and Geriatric Cardiology Working Groups of the Spanish Society of Cardiology, addresses various aspects related to palliative care, where most cardiovascular disease will eventually converge.

[The challenge of clinical complexity in the 21st century: Could frailty indexes be the answer?].

The number of older people with complex clinical conditions and complex care needs continues to increase in the population. This is presenting many challenges to healthcare professionals and healthcare systems. In the face of these challenges, approaches are required that are practical and feasible.

Palliative peritoneal dialysis: Implementation of a home care programme for terminal patients treated with peritoneal dialysis (PD).

Terminal-stage patients on peritoneal dialysis (PD) are often transferred to haemodialysis as they are unable to perform the dialysis technique themselves since their functional capacities are reduced. We present our experience with five patients on PD with a shortterm life-threatening condition, whose treatment was shared by primary care units and who were treated with a PD modality adapted to their circumstances, which we call Palliative Peritoneal Dialysis.

Home Palliative Care for Patients with Advanced Chronic Kidney Disease: Preliminary Results.

Healthcare for patients with advanced chronic kidney disease (ACKD) on conservative treatment very often poses healthcare problems that are difficult to solve. At the end of 2011, we began a program based on the care and monitoring of these patients by Primary Care Teams. ACKD patients who opted for conservative treatment were offered the chance to be cared for mainly at home by the Primary Care doctor and nurse, under the coordination of the Palliative Care Unit and the Nephrology Department.

Home care programme for patients with advanced chronic kidney disease. A two-year experience.

Introduction:  Healthcare for patients with advanced chronic kidney disease (ACKD) on conservative treatment very often poses healthcare problems that are difficult to solve. Many patients are elderly and have mobility problems, and it is very difficult for them to travel to hospital. At the end of 2011, we began a programme based on the care and monitoring of these patients by Primary Care teams.

Drug therapy optimization at the end of life.

Older people reaching end-of-life status are particularly at risk of adverse effects of drug therapy. Polypharmacy, declining organ function, co-morbidity, malnutrition, cachexia and changes in body composition all sum up to increase the risk of many drug-related problems in individuals who receive end-of-life care. End of life is defined by a limited lifespan or advanced disability.

End-stage heart disease in the elderly.

This document was produced by the Spanish Society of Cardiology Section on Geriatric Cardiology "End-stage heart disease in the elderly" working group. Its aim was to provide an expert overview that would increase understanding of the last days of life of elderly patients with heart disease and improve treatment and clinical decision-making. As elderly heart disease patients form a heterogeneous group, thorough clinical evaluation is essential, in particular to identify factors that could influence prognosis (e.