Older people with cancer are a large, diverse and growing group. Forty-five percent of Victoria’s annual cancer diagnoses are in those aged over 70. The rural Wimmera region’s rate is 48%. The Wimmera Health Care Group (WHCG) cancer team aimed to address their needs with a nursing and allied health professional quality improvement project.
The aim was to enhance the care of the older person with cancer by improving knowledge and awareness in the clinical team members. The objectives were to use a tool completed by patients and frequent supportive care multidisciplinary meetings (SCMDM) to plan care for older people with cancer, and to use agreed action between older people and the clinical team to guide ongoing support and care.
Several validated tools within a comprehensive geriatric assessment, some unfamiliar in the cancer sector, assisted the SCMDM discussion. External services and allied health clinicians contributed to discussion and care. Follow up actions are reported at future meetings to provide updates. Improvements occur via patient experience, team member surveys, and data interpretation. WHCG and Grampians Integrated Cancer Service share project coordination.
Eighty-one cases were discussed. Indicated functional status demonstrates that 27.25% are ‘fit’, 56.25% are ‘vulnerable’ and 16.25% are ‘frail’. Five fields provide the status score. Other data showed 63% were aged over 70, 59% took 5 or more daily medications, 31% had hypertension, 30% had memory problems and 21% had falls in the last 6 months. Continence problems were common, which was an unexpected finding. Referrals recommended were 136 of which 88 were accepted.
Using patient experience has developed awareness of age-specific individual issues. This streamlines recommended care. The multidisciplinary meeting environment has also fostered improved relationships and respect between disciplines, developed understanding of relevant issues of those affected by cancer and led to quality improvements in the project.