Improving Cancer Care in Nursing Homes

With a growing elderly population, and more effective treatments to extend life, it is expected that there will be a continuing rise in the incidence of cancer among older adults.  But in nursing homes, there may be challenges to providing cancer care and yet treatment in hospitals can often cause anxiety, delirium, and other health risks, especially for frail older adults. 

According to a recent McMaster Optimal Aging Portal blog post, in some cases after the age of 75, screening and treating for some cancers may cause more harm to elderly patients than benefit.  Although each patient is different, in many situations, focusing on palliative or comfort care rather than treating cancers provides a better quality of life for older adults living in nursing homes. 

There are, however, barriers to providing cancer care in nursing homes that include a lack of knowledge among staff, as well as organizational, cultural, and ethical challenges.  A lack of resources or communication problems with patients who have dementia can also make it difficult to provide medical care to treat cancer.   It can be a struggle to balance the potential harms and benefits of treatments for cancer patients in assisted living facilities. 

Studies have shown that although cancer is prevalent among elderly adults, nursing homes tend to screen for the disease less often than recommended.  The lack of earlier diagnosis among nursing home residents may be due to missed symptoms, lack of testing, or dismissing the symptoms experienced by elderly patients.   Arranging for tests and appointments may be a challenge in understaffed facilities. 

With proper communication and earlier diagnosis, older adults are more likely to accept treatment for cancer after weighing the quality of life benefits with the potential side effects.  To better care for seniors in long-term care facilities, researchers have found that staff would benefit from continuing education on geriatric oncology, screening recommendations, treatments, and communicating with patients that have cognitive impairments.