Cancer in home care: unintended weight loss and ethical challenges. A cross-sectional study of older people at 11 sites in Europe.

The aim of this study was to compare unintended weight loss in cancer patients to other elderly. Home care users, aged ≥65 from urban areas at 11 sites in Europe (N=4010) were assessed with the Resident Assessment Instrument for Home Care. Epidemiological and medical characteristics of clients and service utilization were recorded. A total of 321 (8%) patients had a cancer diagnosis; they were on average 80.4±7.3 years. Socio-demographic, functional and clinical parameters revealed small variations in the two groups. Compared to the non-cancer group, they more frequently suffered from: severe malnutrition (odds ratio=OR=2.4) unintended weight loss (OR=2.0), had been hospitalized during the last 6 months (OR=1.8). Older patients with cancer suffer more frequently from problems associated with nutrition than non-cancer patients. A comprehensive assessment could lead to better management of food and fluid supply based on basic ethical principles.