Association between patient dignity and anxiety in geriatric palliative care

1. Linda Mah
   1. Rotman Research Institute, Baycrest; Department of Psychiatry, Baycrest; Department of Psychiatry, Division of Geriatric Psychiatry, University of Toronto, Toronto, ON, Canada
2. Daphna Grossman
   1. Department of Family and Community Medicine, Baycrest; Department of Family and Community Medicine, Division of Palliative Care, University of Toronto, Toronto, ON, Canada
3. Cindy Grief
   1. Department of Psychiatry, Baycrest; Department of Psychiatry, Division of Geriatric Psychiatry, University of Toronto, Toronto, ON, Canada
4. Mark Rootenberg
   1. Honours BSc Candidate, York University
   2. Department of Family and Community Medicine, Baycrest, Toronto, ON, Canada

1. Linda Mah, Rotman Research Institute, Baycrest Division of Geriatric Psychiatry, University of Toronto 3560 Bathurst Street Toronto, ON, Canada M6A 2E1 Email: lmah@research.baycrest.org

Preservation of patient dignity is increasingly an important focus in end-of-life care and research. However, the experience of terminally-ill older adults has rarely been systematically examined. We previously reported results of a pilot study using Chochinov’s Patient Dignity Inventory¹ in a Geriatric Palliative Care Unit (PCU).² While greater dignity-related distress was experienced amongst geriatric PCU patients, the specific PDI items identified as concerns were remarkably consistent with studies of cancer patients across the adult lifespan in community and hospital settings.^3,4 We extend our previous findings with a report on associations amongst dignity-related concerns and clinical severity of mood, anxiety, and physical symptomatology.

Twenty-seven patients admitted to the PCU in a tertiary care geriatric hospital were studied (14 males, mean age = 80 years (SD = 9.8), mean Palliative Performance Scale score = 49.2% (SD 9.3)). Primary admitting diagnoses were cancer (n = 23), congestive heart failure (n = 3) and beta-thalassemia disease (n = 1). Mean duration of survival was 106 days (SD = 72.9) from the time of testing, with 25 patients deceased by the study end. All patients completed the Edmonton Symptom Assessment Scale (ESAS), …

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