Necessidades paliativas em estruturas residenciais para pessoas idosas

: necessidades dos doentes e capacitação dos profissionais

Abstract

Introduction: Portugal stands out as one of the countries where global population aging is particularly pronounced, making the institutionalization of elderly individuals in nursing homes increasingly important. On the other hand, longevity is associated with an accumulation of chronic illnesses, which in turn leads to the emergence of geriatric syndromes (such as frailty) and an increase in vulnerability and dependency. Palliative care aims to promote quality of life, especially in potentially life-threatening situations. This context suggests the existence of a range of palliative care needs among the elderly, particularly nursing home residents, making it essential to identify and address these needs. Objectives: To determine the prevalence of palliative needs among nursing home residents at the SCMM and to characterize them. Methodology: This is an observational, analytical, cross-sectional study with a quantitative approach. A questionnaire was used to characterize the residents, and three assessment tools were applied: the NECPAL (Palliative Needs Assessment Tool) version 3.1, the Integrated Palliative Care Outcome Scale (iPOS) version 2, and the Palliative Performance Scale (PPS-PT) to evaluate functionality and prognosis. Results: Data were collected from 57 residents, with a median age of 85 years. Dementia (44.4%) and frailty (42.1%) were the most prevalent clinical conditions. According to the NECPAL tool, 25 residents were identified as having palliative needs (43.8%), with a median of 4 on the NECPAL scale for severity/progression/advanced illness criteria. When applying the iPOS, NECPAL+ residents showed a higher prevalence of symptoms such as pain (60% vs 31.3%), weakness (60% vs 34.4%), constipation (76% vs 34.4%), mouth sores or dry mouth (72% vs 40.6%), drowsiness (72% vs 40.6%), worry/anxiety (76% vs 21.9%), and depression (84% vs 15.6%). Conclusions: The significant prevalence of palliative care needs found in this population and the lack of referral to specialized care demonstrate insufficient identification of these needs. To improve the care provided to nursing home residents, it is essential to enhance the training of healthcare professionals in palliative care and to systematically apply tools like NECPAL.

Date of Award	18 Dec 2024
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Manuel Luís Capelas (Supervisor)