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Purpose of Review <p>To explore the utilization of palliative care consultation (PCC) and management in geriatric trauma patients, through the lens of trauma-informed care (TIC) and identify areas to improve palliative care utilization in this growing population.</p> Recent Findings <p>PCC is often obtained in a delayed fashion, often beyond the recommended 72-hour time frame. There is a wide variability in early palliative care (EPC) utilization, despite its benefits of reducing hospital and ICU LOS, reduced costs, and improved patient satisfaction. To assist in prognostication, the Palliative Performance Scale, Trauma-Specific Frailty Index and Geriatric Trauma Outcome Score can be employed. These scoring systems can guide clinicians in obtaining EPC and frame the conversation based on projected outcomes. TIC and palliative conversations have many overlapping concepts, and PCC with a focus on TIC allows for treatment of the whole person. There are racial, socioeconomic, geographic, age-related, and sexual identity-related disparities in PCC. PCC perception may contribute to some of these disparities, especially when considering provider perception.</p> Summary <p>The authors recommend continued education for clinicians and hospital staff on determining the utility of EPC in geriatric trauma patients. Employing “The Surprise Question” and concepts discussed in the TQIP Best Practice and AAST Guidelines can assist in ensuring patients receive care aligned with their personal goals and wishes. Even if PCC isn’t obtained, a discussion about goals of care and appointment of surrogate decision maker should be conducted.</p>

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Considerations and Recommendations for Palliative Care Management in the Geriatric Trauma Population

  • 期刊论文

  • 发表日期：

    2026年4月2日

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  • Brent Blackwell,
  • Christopher Demme,
  • Abigail Dickinson,
  • Elizabeth Kim,
  • Jared Griffard

摘要

Purpose of Review

To explore the utilization of palliative care consultation (PCC) and management in geriatric trauma patients, through the lens of trauma-informed care (TIC) and identify areas to improve palliative care utilization in this growing population.

Recent Findings

PCC is often obtained in a delayed fashion, often beyond the recommended 72-hour time frame. There is a wide variability in early palliative care (EPC) utilization, despite its benefits of reducing hospital and ICU LOS, reduced costs, and improved patient satisfaction. To assist in prognostication, the Palliative Performance Scale, Trauma-Specific Frailty Index and Geriatric Trauma Outcome Score can be employed. These scoring systems can guide clinicians in obtaining EPC and frame the conversation based on projected outcomes. TIC and palliative conversations have many overlapping concepts, and PCC with a focus on TIC allows for treatment of the whole person. There are racial, socioeconomic, geographic, age-related, and sexual identity-related disparities in PCC. PCC perception may contribute to some of these disparities, especially when considering provider perception.

Summary

The authors recommend continued education for clinicians and hospital staff on determining the utility of EPC in geriatric trauma patients. Employing “The Surprise Question” and concepts discussed in the TQIP Best Practice and AAST Guidelines can assist in ensuring patients receive care aligned with their personal goals and wishes. Even if PCC isn’t obtained, a discussion about goals of care and appointment of surrogate decision maker should be conducted.