Barriers to Palliative Care Utilization in Elderly People with Cancer: A Systematic Review

Introduction: The number of elderly people with cancer and the need for palliative care among this population is increasing in the world. Despite the proven benefits of palliative care in physical, emotional, psychological and spiritual dimensions, it is an underutilized form of care among the elderly. The object of this systematic review study was to investigate the barriers to access palliative care in the elderly people with cancer.Material and Methods: A systematic review search was conducted using PubMed, Google Scholar, SID (from ۲۰۱۲ to ۲۰۲۲). Research articles that examined barriers to palliative or supportive care utilization in elderly with cancer were included in this review. To facilitate the search by using the appropriate keywords, the terms (palliative care OR supportive care OR hospice care) AND (cancer OR neoplasm) AND (barriers OR obstacles) were used. Then, the full text of the articles that have carefully examined the barriers to access to palliative care in the elderly, and were published in English and Persian, were selected. A total ۱۲ studies related to the research topic were selected and analyzed in this review.Results: The finding of this study identified a range of barriers and challenges to accessing palliative care, including: lack of awareness of the existence of palliative care, low education level, being urban or rural, misperception of palliative care as end-of-life care, cultural restrictions, lack of communication with care providers, denial of illness and lack of social perception that cause not to refer to caregivers.Conclusion: Barriers to palliative care utilization that were identified in this review, provide guidance for identifying and developing intervention to facilitate access to palliative care in elderly people with cancer. Palliative care interventions may have more benefical effects on quality of life and symptom intensity among elderly patient with cancer, therefore it is suggested that the necessary plan and policies and allocation of resources be carried out in relation to cultivation, education.

Keywords:

Elderly , Cancer , Palliative Care , Barriers.