PS 8 - D improving palliative care for older people: innovative care approaches: EAPC white paper: an integrated palliative, geriatric, and rehabilitative care approach for frail older people

Background: To date, there is no consensus on what optimal palliative care for older people with frailty entails. The EAPC Reference Group on Aging and Palliative Care aimed to identify key domains and recommendations for optimal integrative palliative, geriatric and rehabilitative care in frailty, based on evidence and expert consensus. Methods: International Delphi study (6 rounds) gathering collective opinion of experts in frailty and palliative, geriatric and rehabilitative care, and experts by experience, while considering relevant empirical evidence. Results: We have differentiated between 12 domains defining an integrative palliative, geriatric and rehabilitative care approach for older people with frailty and their family: 1applicable to all older people living with frailty 2multidimensional and holistic; focused on capacities and needs3goal-oriented and guided by older people’s values, priorities, and preferences4pro-active, including advance care planning, parallel planning, emergency-response and out-of-hours planning 5high-quality communication and shared decision-making 6dying with comfort, dignity and choice 7family as care provider and care recipient 8integrated approach to care: interdisciplinary, well-coordinated across settings, and timely and equitable access to services9delivered by competent professionals 10sensitive to context and culture 11supportive of community initiatives and public health approaches 12based on sound ethical principles and frameworks Importance of these domains and agreements with recommendations for each domain will be scored by an international group of professional experts and representatives of older people and their families (N=90), with the aim of reaching consensus among experts.Conclusion: This work will lay the foundations for future research, practice, and policy, to ensure all older people living with frailty and their families receive the care and support needed to live and die well.