Up next in 10
The Ultimate Guide for Geriatric Assessment in Older Adults with Cancer is based on the paper published at
https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21864
The authors provide a very comprehensive review of care for older adults with cancer, and how, why, and in what context geriatric assessment should be added to the routine care and assessment of older adults with cancer. They conduct a deep dive into the opportunities and challenges of geriatric assessment in oncology clinics, and also touch on novel technologies.
Connect with me via
LinkedIn https://www.linkedin.com/in/arminshahrokni?utm_source=share&utm_campaign=share_via&utm_content=profile&utm_medium=android_app
X
https://x.com/GeriOncologist?t=QMpM6F9KTB9_2W66OiEOzw&s=09
Instagram
https://www.instagram.com/aging_cancer/profilecard/?igsh=MXI3eTBieTNhNjJucg==
Google Scholar
Show More Show Less View Video Transcript
0:05
okay let's jump straight in the world is
0:08
well it's getting older and
0:09
unfortunately that means more people are
0:11
facing cancer in their later years but
0:13
here's the critical twist older adult
0:17
isn't really a single category is it not
0:19
at all someone in their 70s might be
0:21
running marathons while you know another
0:23
person in their 60s could be managing
0:25
multiple serious health issues how they
0:28
handle cancer treatment their symptoms
0:30
their whole experience it's incredibly
0:32
varied exactly and this is where um
0:36
traditional ways of thinking in oncology
0:38
really start to fall short how so well
0:40
just looking at a patient's
0:41
chronological age or using simple scales
0:45
like ECOG or Carnovski which mainly
0:48
score how well someone moves around they
0:50
just don't capture that individual
0:52
complexity in fact those simple scores
0:54
can sometimes penalize older adults
0:56
making them seem less capable than they
0:58
really are in their sort of daily lives
1:00
they miss so much of the real person
1:01
right like um can they cook for
1:03
themselves do they have family nearby to
1:05
help how many medications are they
1:06
juggling that's the stuff that truly
1:08
impacts how someone navigates something
1:10
as tough as cancer treatment and that's
1:13
exactly what we're digging into today
1:14
we're doing a deep dive into this
1:16
important article from CA a cancer
1:19
journal for clinicians which is uh
1:22
essentially a guide for clinicians on
1:23
geriatric assessment in cancer care yeah
1:26
and our mission with this deep dive is
1:27
really to give you a clear quick
1:29
understanding of this vital tool we'll
1:31
explore why this comprehensive approach
1:33
is now essential what exactly goes into
1:36
it and maybe most importantly how it's
1:39
actually being put into practice to make
1:40
a real difference a difference for older
1:42
adults with cancer and also for the
1:44
people who care for them which is key
1:46
absolutely for the caregivers too so
1:48
let's get to the heart of it what is
1:50
geriatric assessment or GA as it's
1:52
commonly called okay so think of GA as a
1:56
like a 360°ree look at an older person's
1:59
health status it goes way beyond just
2:02
the cancer diagnosis it's a structured
2:04
way to evaluate several key dimensions
2:06
of their life and health and what are
2:07
those dimensions what kind of things are
2:09
they looking at specifically well the
2:11
paper highlights some critical areas
2:13
there's physical performance you know
2:15
how they move functional status which is
2:18
often split into activities of daily
2:20
living or ADLs the basics yeah the
2:22
basics like bathing or getting dressed
2:25
and then instrumental activities of
2:27
daily living IADLs that's the more
2:30
complex stuff like managing finances
2:32
shopping using the phone okay it also
2:34
assesses other medical conditions uh
2:36
known as coorbidity and importantly how
2:39
many medications someone is taking
2:41
that's polyfarm pharmacy which can get
2:42
complicated really quickly for older
2:44
adults absolutely plus it covers
2:46
nutrition how sharp their cognitive
2:48
function is their social support system
2:50
you know who's there for them and their
2:52
psychological state like mood and
2:54
anxiety levels okay so compared to just
2:56
saying your ECOG score is two which you
2:59
know might mean you're mostly up but
3:01
can't do strenuous activity GA tells you
3:04
if that person can still live
3:05
independently manage their bills and has
3:07
someone checking in on them that's a
3:09
completely different level of detail it
3:12
is and the article points out that while
3:14
traditional performance scores like ECOG
3:16
or Carnovski they're pretty good at
3:18
flagging physical limitations uhhuh they
3:21
don't correlate nearly as well with
3:22
those other critical domains GA captures
3:24
like cognitive function or social
3:26
support ga gives you the actual picture
3:29
of someone's life and well their
3:32
resilience this detailed picture sounds
3:34
incredibly useful but why does it make
3:36
such a difference specifically in cancer
3:39
treatment what can GA actually predict
3:42
about a patient's journey this is really
3:44
where the rubber meets the road ga
3:46
information is a much much stronger
3:48
predictor than age alone of how well an
3:51
older person will tolerate cancer
3:52
treatment particularly intensive
3:54
therapies like chemotherapy so it can
3:56
actually predict who might have severe
3:57
side effects like really bad ones
3:59
exactly researchers have used GA data to
4:01
build validated predictive models these
4:04
are specifically designed to estimate
4:06
the risk of serious chemotherapy
4:07
toxicity we're talking those
4:09
clinicianrated grade 3 to five adverse
4:12
events the paper mentions models like
4:14
CARG for solid tumors and crash which is
4:17
used for solid tumors and also lymphas
4:19
and hematlogic malignancies so these
4:22
aren't just like educated guesses
4:23
they're validated tools based on data
4:27
right they take specific variables
4:29
directly from the GA things like a
4:31
history of falls how active someone is
4:33
socially or even their hearing ability
4:36
for the card model interesting iadl's
4:39
cognition and nutrition for the ciderish
4:41
model and they use them to stratify a
4:43
patient's risk level for severe toxicity
4:46
and do certain things pop up again and
4:47
again well yeah while the exact
4:49
variables might differ a bit between the
4:51
models domains like fall history and
4:53
overall physical function consistently
4:55
show up as strong predictors across the
4:57
board and is this something that adds
4:59
hours to a clinic visit because you know
5:02
time is always a factor that's a great
5:03
point and a common concern the article
5:06
notes that the CARG model can take less
5:08
than 5 minutes to complete 5 minutes
5:10
that's it yeah the cy model is a bit
5:12
more comprehensive takes about 20 to 30
5:14
minutes so it's designed to be feasible
5:16
within a busy clinical setting you
5:17
mentioned lymphas and hematic
5:19
malignancies with CRS does GA play a
5:22
role in predicting outcomes in blood
5:25
cancer specifically beyond just
5:27
chemotoxicity absolutely ga variables
5:30
are powerful predictors of crucial
5:31
outcomes in blood cancers like acute
5:34
myoid leukemia AML myoidis plastic
5:36
syndromes MDS multiple myyoma and
5:39
lymphoma things like overall survival
5:41
and how long someone can actually stay
5:43
on their treatment are there specific
5:44
tools for those blood cancers yes there
5:47
are disease specific risk scores that
5:48
incorporate GA like factors for example
5:51
um there's the elderly prognostic index
5:53
for a type of lymphoma called DLBCL it
5:56
includes age coorbidities and functional
5:59
status alongside disease features okay
6:01
an MDS specific frailty index uses
6:03
things like fatigue and interestingly
6:06
ability to prepare meals and for
6:07
multiple myyoma there's an international
6:09
myoma working group frailty score using
6:12
age coorbidities and function so the
6:14
message is the key takeaway here is that
6:16
if you routinely collect ADLs IDLs and
6:18
coorbidity information using GA you're
6:20
already getting the data needed to apply
6:22
these specific validated risk scores for
6:24
blood cancers okay so GA helps predict
6:27
risks which is vital for anticipating
6:29
problems maybe preventing them but does
6:32
it actually change how treatment is
6:34
given does it guide clinical decisions
6:36
it fundamentally does yes the paper
6:38
highlights a systematic review showing
6:40
that incorporating GA results changed
6:42
the plan treatment course in a
6:44
significant number of patients 31% wow
6:47
nearly a third yeah and often this led
6:50
to doctors opting for a less intensive
6:52
treatment approach less intensive
6:54
meaning potentially easier to tolerate
6:56
but still effective against the cancer
6:58
is that the idea precisely the goal is
7:00
to tailor the treatment to the person
7:02
not just the disease label or the age
7:04
makes sense the article gives examples
7:06
from trials in a lung cancer study ESOA
7:09
using GA to guide treatment decisions
7:11
led to fewer toxicities and actually
7:13
increased treatment failure-free
7:16
survival patients stayed on treatment
7:18
longer without major issues that's a
7:20
massive benefit reducing toxicity while
7:23
maintaining or even improving treatment
7:24
duration that's huge it is an analyoma
7:27
trial anziner 3 using a less intensive
7:31
chemotherapy regimen guided by a GA like
7:33
assessment was just as effective as the
7:36
standard regimen in fitter older
7:38
patients okay and even better for very
7:40
old patients with lower risk disease
7:42
mainly because it was better tolerated
7:44
so this isn't just about predicting
7:45
problems it's really about making
7:47
smarter safer choices for the individual
7:49
patient based on their overall health
7:51
exactly and that brings us neatly to the
7:54
crucial second step geriatric assessment
7:56
management or GAM okay so GA is the
7:59
assessment getting that detailed picture
8:01
jam is taking that picture and actually
8:03
doing something about what you see
8:05
that's the perfect way to think about it
8:07
gam takes the specific impairments
8:09
identified during the GA maybe it's poor
8:11
balance difficulty managing medications
8:14
maybe nutritional issues and it triggers
8:17
tailored interventions to address those
8:18
specific problems it turns assessment
8:20
into action and this aligns so well with
8:23
what older adults themselves often
8:25
prioritize doesn't it you hear things
8:27
like maintaining their independence
8:29
staying active keeping their mind sharp
8:31
absolutely gam directly targets those
8:34
quality of life outcomes that matter so
8:36
much if the GA shows someone is at high
8:39
risk for falls right gm means getting
8:41
them to physical therapy maybe doing a
8:43
home safety check if they have polyfarm
8:45
pharmacy issues it triggers a medication
8:47
review perhaps by a pharmacist
8:49
nutritional problems mean a referral to
8:51
a dietitian so these interventions
8:53
aren't necessarily just about fighting
8:54
the cancer directly they're about
8:56
supporting the whole person's health
8:58
building them up that's key the paper
9:00
mentions that recommendations for
9:02
non-oncologic interventions things like
9:04
improving social support nutrition
9:06
managing medications these come up in
9:08
over 70% of patients who get a GA it's
9:11
about building a foundation of overall
9:12
health to better withstand the cancer
9:15
treatment itself okay so is there
9:16
concrete evidence that doing JAM taking
9:19
these actions actually improves things
9:21
for patients does it work yes there's
9:23
strong evidence now from numerous
9:25
clinical trials and large analyses meta
9:27
analyses gam has been shown to improve
9:30
really important outcomes like what
9:31
patients are more likely to complete
9:33
their plan treatment they report better
9:35
quality of life communication with their
9:37
care team improves and important
9:39
conversations like advanced care
9:40
planning are more likely to happen and
9:42
what about reducing those negative
9:43
outcomes we talked about earlier like
9:45
toxicity precisely it lowers the risk of
9:48
treatment related toxicity it reduces
9:50
falls and it helps manage polyarm
9:52
pharmacy a meta analysis specifically
9:55
found a significantly lower risk of
9:57
treatment toxicity when GAM was
9:59
implemented compared to usual care
10:01
reducing severe toxicity I mean that's a
10:04
massive impact on someone's well-being
10:05
during a tough treatment it really is
10:08
the article highlights several key
10:09
trials demonstrating these benefits the
10:11
Gaines study which involved a geriatric
10:14
multiddisciplinary team saw over a 10%
10:17
absolute reduction in severe
10:18
chemotherapy toxicity wow and increased
10:21
completion of advanced directives the
10:23
Jericho study focused on frail colarctal
10:26
cancer patients and found higher rates
10:28
of completing plan treatment and
10:29
improvements in quality of life and
10:31
mobility real tangible improvements in
10:33
how people feel and function dayto-day
10:36
exactly another trial integrate showed
10:39
patients who received an integrated
10:41
geriatrician consultation maintain their
10:43
social function better and had fewer
10:45
unplanned hospitalizations and perhaps
10:48
one of the most compelling go on the
10:49
GAP7 plus study this used an algorithm
10:53
to provide GA based recommendations
10:55
directly to oncology teams in community
10:57
practices not just academic centers and
11:00
what did GAP7 plus show in that
11:03
community setting it showed a marked
11:04
reduction in clinician rated toxicities
11:07
dropping from 70% in the control group
11:09
down to 50% in the group receiving the
11:11
JAM recommendations that's huge patients
11:14
also reported less toxicity themselves
11:16
they saw fewer falls improvements in
11:18
polyfarm pharmacy management and
11:19
interestingly increased initial dose
11:21
reductions based on the GA results which
11:24
might make some people nervous right but
11:26
crucially without harming overall
11:28
survival outcomes the code trial had a
11:30
similar design and showed improved
11:32
communication about aging related issues
11:34
and higher satisfaction for both
11:35
patients and their caregivers okay so
11:38
the evidence base seems really solid
11:40
taking action on GA results leads to
11:42
better outcomes across the board even if
11:45
you know a few smaller trials maybe
11:46
haven't shown clear benefits possibly
11:49
due to their specific design or maybe
11:50
outside factors like the pandemic
11:52
messing things up yeah the overall
11:54
utility is well established now and it's
11:57
why major cancer organizations like ASCO
11:59
and SCIOG now recommend incorporating GA
12:02
and GAM into routine care for older
12:05
adults okay so with all this compelling
12:07
evidence the guidelines now recommending
12:09
it you'd think GA and GAM would be
12:11
standard practice everywhere by now but
12:13
the article points out that's just not
12:15
the case right still lagging that's the
12:17
big challenge yeah despite the known
12:19
benefits routine implementation the
12:21
actual uptake in everyday oncology
12:23
practices is still quite low a survey
12:25
cited the paper found only maybe 22% of
12:28
oncology providers are regularly using
12:30
GA only 22% that's a tiny fraction why
12:33
such a big gap between knowing something
12:35
works and actually doing it consistently
12:38
well the article delves into the
12:39
barriers providers report the most
12:41
common ones are things like lack of
12:42
dedicated support staff lack of time
12:45
during busy clinic visits feeling like
12:47
they don't have enough knowledge or
12:48
training on how to perform GA or what to
12:50
do with the results uncertainty yeah
12:52
uncertainty about which tools to use
12:54
competing priorities within the clinic
12:56
or the institution and just difficulty
12:59
linking patients to the right supportive
13:00
care services or specialists after the
13:02
assessment is done so referral pathways
13:05
exactly and it seems concerns about
13:07
resources and time are pretty universal
13:09
but providers who are less familiar with
13:11
the guidelines also feel less confident
13:13
in their own knowledge about it okay so
13:15
if those are the barriers time staff
13:19
knowledge pathways how do we overcome
13:22
them how do we make GA practical in the
13:24
real world day in day out so the paper
13:27
discusses strategies framed around this
13:28
idea of increasing capability
13:30
opportunity and motivation for
13:32
clinicians the COM model a key
13:35
development to directly address the time
13:36
and resource issue is the creation of
13:38
simpler more practical GA tools like
13:41
what give me an example like the
13:43
practical geriatric assessment or PGA
13:45
this is developed by ASCO and curric
13:48
it's designed specifically for routine
13:50
clinical practice it's mostly patient
13:52
reported which saves staff time oh it
13:54
takes only about 10 to 25 minutes covers
13:57
the core GA domains gives you clear
13:59
score cut offs and even includes an
14:01
action chart that quickly translates the
14:02
results into recommendations things like
14:05
specific referrals or suggesting dose
14:07
adjustments that sounds much more
14:09
userfriendly for a busy clinic
14:10
environment less daunting exactly but
14:13
tools aren't enough right engaging the
14:15
whole oncology team is crucial how do
14:17
you do that well it means providing
14:19
education to build knowledge and
14:21
importantly bust some myths about how
14:23
long GA really takes and providing
14:26
training to build comfort and skill in
14:28
administering and interpreting the
14:29
assessments it also often requires
14:31
rethinking how things actually flow in
14:33
the clinic day-to-day how can workflow
14:35
help changing the process yeah you need
14:38
to integrate GA into the existing
14:40
process not make it feel like some extra
14:42
thing tacked on the article gives
14:44
examples having patients complete parts
14:46
of the assessment online before the
14:47
visit right using portal technology or
14:50
having a medical assistant or nurse
14:52
complete other parts during the rooming
14:54
process using the electronic health
14:56
record the EHR to automatically score it
14:59
and maybe even pop up suggested
15:00
recommendations for the doctor or nurse
15:02
practitioner to review embedding GA into
15:05
the workflow provides the opportunity
15:08
and makes it less of a separate burden
15:09
and who drives that kind of change who
15:11
makes it happen it really requires
15:13
clinical champions within the practice
15:15
you need people who are enthusiastic and
15:17
can lead the implementation effort so
15:19
doctors nurses yeah often physicians
15:22
nurses or PAs they can form teams to
15:24
manage the whole process from exploring
15:26
options preparing the staff implementing
15:28
the changes and crucially sustaining it
15:31
long term that includes checking if it's
15:33
actually working providing feedback and
15:35
there are resources out there from
15:37
organizations like CARIG CO ACCCC to
15:40
help practices do this you mentioned
15:42
using electronic health records how else
15:44
can technology help with getting GA and
15:46
JM implemented more widely technology is
15:49
becoming a huge enabler here collecting
15:52
GA data digitally whether it's through
15:54
patient portals or web-based tools is
15:57
increasingly feasible even for older
15:59
adults there's that talk of the digital
16:01
divide well the paper notes that while
16:03
that's been a concern the gap is closing
16:06
rapidly we've seen significantly
16:08
increased smartphone and internet use
16:10
among older adults in recent years so
16:13
tech adoption is rising and EHR
16:15
integration is key for making the
16:17
assessment and the resulting
16:18
recommendations just part of the routine
16:21
clinical flow not a separate spreadsheet
16:22
somewhere and tele medicine that
16:24
exploded recently does that fit in oh
16:26
absolutely tele medicine is a natural
16:28
fit for delivering GA and JAM especially
16:30
the consultative parts it allows for
16:32
virtual assessments remote communication
16:34
of action plans to patients and their
16:36
caregivers right and easier access to
16:38
those supportive care specialists like
16:40
physical therapists or social workers
16:42
this is particularly valuable for
16:43
patients in rural areas or maybe those
16:45
with mobility issues who find travel
16:47
difficult hybrid models using both
16:50
virtual and in-person elements are also
16:52
being explored what about things like
16:54
you know smartwatches or fitness
16:56
trackers wearables yeah mobile health
16:59
technology like wearables can provide
17:01
real-time data on things like activity
17:03
levels gate patterns maybe even vital
17:05
signs or sleep this data could
17:07
potentially alert the care team to
17:09
changes in a patients status between
17:11
visits or help tailor recommendations
17:13
like exercise plans more dynamically
17:16
okay so now we're talking about
17:17
generating a huge amount of data from
17:19
lots of different places the GA the EHR
17:22
wearables what about advanced analytics
17:24
AI yeah that's definitely the frontier
17:27
machine learning and AI have the
17:29
potential to combine all this diverse
17:30
data the GA results the EHR data claims
17:34
data maybe wearable sensor data to
17:36
create even more powerful predictive
17:38
models than we have now like what well
17:40
imagine as a sort of digital twin for a
17:42
patient using all this information to
17:44
simulate how they might respond to
17:45
different treatment options before you
17:47
even start wow that sounds really
17:49
exciting almost science fiction what are
17:51
the hurdles to getting there it can't be
17:52
simple no there are significant
17:54
challenges lack of infrastructure to
17:56
actually combine these massive data sets
17:58
from different sources is a major one
18:01
data sharing is complex technically and
18:03
legally and ethically absolutely there
18:06
are important ethical concerns ensuring
18:09
patient privacy and data security is
18:11
paramount addressing potential bias in
18:14
algorithms we don't want them
18:16
disadvantaging certain groups ensuring
18:18
equitable access to these advanced
18:20
technologies and making sure the AI's
18:22
recommendations are transparent and
18:24
understandable not just a black box okay
18:27
so while the promise is huge
18:28
implementing advanced tech for GA needs
18:30
really careful consideration of the
18:32
practical and the ethical implications
18:34
that makes sense now as the older
18:36
population itself diversifies how does
18:38
GA fit into ensuring equitable care for
18:41
everyone not just the majority
18:43
population this is a critical area the
18:45
article really highlights the older
18:46
adult population is becoming
18:48
increasingly diverse racially and
18:49
ethnically and we know that structural
18:51
inequities things like systemic racism
18:54
contribute significantly to health
18:55
disparities so how can GA help well GA
18:58
has the potential to reveal important
19:00
social determinants of health that
19:02
impact care especially if you use tools
19:05
that maybe assess community level needs
19:07
or social vulnerability alongside the
19:10
individual assessment so it can help us
19:12
see that bigger picture beyond just the
19:14
medical conditions the social context
19:16
yes exactly yeah but a challenge is that
19:19
most of the research on GA and JAM so
19:21
far has involved patient populations
19:23
that aren't very diverse often majority
19:26
white participants there's a real need
19:28
to figure out how to effectively
19:30
implement practical GA approaches in
19:32
underserved communities and rural areas
19:34
where diversity is often greatest and
19:36
language barriers must complicate things
19:38
even further right they absolutely do a
19:41
significant portion of the population
19:42
speaks English less than fluently and a
19:45
large percentage of those are older
19:46
adults language barriers severely impact
19:48
communication the quality of care people
19:50
receive their adherence to treatment
19:52
safety it contributes to mistrust and
19:55
potential discrimination we saw this
19:57
amplified during the pandemic actually
19:59
with lower tele medicine use among some
20:01
non-English-speaking patient groups so
20:03
how can GA help bridge that specific gap
20:06
well GA interventions that focus on
20:08
improving communication like those
20:10
tested in the COC trial could certainly
20:12
help but fundamentally delivering truly
20:14
patient centered care for people with
20:16
limited English proficiency means really
20:19
understanding their preferences within
20:20
their specific social and cultural
20:22
context it's not just about translation
20:25
no the article emphasizes the need for
20:27
research to actively include diverse
20:29
populations and focus on solutions to
20:31
these complex issues ensuring equitable
20:34
jam requires health systems to actively
20:36
address these social factors through
20:38
awareness adjusting care plans
20:40
accordingly providing assistance like
20:42
interpretation or referrals to community
20:44
resources and even advocating for
20:46
broader system changes it's clear that
20:48
reaching diverse populations equitably
20:50
is a major focus for the future of GA
20:52
the article also shines light on another
20:54
group who are absolutely essential but
20:56
let's be honest often overlooked
20:58
caregivers how does GA relate to their
21:00
needs right caregivers they're often
21:03
older female family members maybe a
21:05
spouse or daughter and they play a vital
21:07
role but frequently experience
21:10
significant burden burden meaning
21:12
meaning negative impacts on their own
21:15
emotional social financial and physical
21:17
well-being and this burden is often
21:19
directly linked to the patients level of
21:22
impairment particularly in those
21:24
activities of daily living and
21:25
instrumental activities of daily living
21:27
that GA measures so well so the patients
21:30
functional limitations directly create
21:33
challenges and stress for the person
21:35
caring for them it's interconnected
21:37
precisely and these caregivers often
21:38
have their own health issues to deal
21:40
with they tend to be in their 60s on
21:42
average with their own medical
21:43
conditions studies consistently show
21:45
caregivers of older adults with cancer
21:47
report higher rates of emotional
21:48
distress physical health problems and
21:51
they're less likely to get preventive
21:52
care for themselves because they're so
21:54
focused on the patient and that burden
21:56
isn't just hard on the caregiver
21:57
personally it can affect the patient's
21:59
care too yeah it can actually impact
22:01
their ability to provide that care
22:03
effectively high caregiver burden has
22:05
been linked to things like more
22:07
hospitalizations for the patient or
22:09
maybe less appropriate end of life care
22:12
because the caregiver is just
22:13
overwhelmed are we getting any better at
22:15
assessing caregiver needs just like
22:17
we're trying to do systematically for
22:19
patients with GA well validated tools
22:22
exist to screen for caregiver distress
22:24
things like the cancer support source
22:26
caregiver tool and studies have shown
22:28
it's feasible to use GA like approaches
22:31
to assess caregivers own health and
22:33
their supportive care needs however
22:35
implementing these tools in routine
22:37
oncology practice is still very limited
22:39
it's not standard yet it sounds like
22:42
similar to the patient side with GA
22:44
moving to GAM we need to move from just
22:46
knowing about caregiver burden to
22:48
actually doing something systematic
22:49
about it exactly while there's been
22:51
research on supportive interventions for
22:53
caregivers things like problem solving
22:55
support or
22:56
psychoeducation these studies have often
22:58
been small lack diversity in their
23:00
participants and the findings can be
23:02
hard to translate into everyday clinical
23:04
practice so what do caregivers
23:06
themselves say they need caregivers
23:08
themselves have identified what they
23:10
need most a workshop highlighted five
23:12
key areas better information and
23:14
training on how to provide care being
23:16
more integrated into the patients care
23:18
team getting help navigating the complex
23:20
health care system more focus and
23:22
support for their own health and broader
23:25
policy changes to support caregiving so
23:28
the future really needs to integrate
23:29
caregiver assessment and support
23:31
directly into the patients geriatric
23:33
assessment management plan recognizing
23:35
they function as a unit a diad and you
23:38
can't effectively care for the patient
23:40
without considering and supporting the
23:42
caregiver too that's absolutely the
23:43
clear direction the field is and needs
23:45
to be moving treating the patient
23:48
caregiver diet okay let's try and bring
23:49
this deep dive together then we've
23:51
explored how geriatric assessment is
23:53
really transforming cancer care for
23:54
older adults it provides this rich
23:57
comprehensive picture that goes way
23:59
beyond simple age or those basic
24:01
physical scores right it's a powerful
24:03
tool for predicting how patients will
24:05
tolerate treatment much better than age
24:07
alone and for guiding smarter more
24:09
personalized therapy decisions and then
24:11
geriatric assessment management GAM
24:14
takes those insights and turns them into
24:16
concrete action implementing tailored
24:18
interventions that we've seen
24:19
significantly improve key outcomes for
24:21
patients reducing toxicity improving
24:24
quality of life enhancing communication
24:27
big impacts yeah and while those
24:28
practical implementation challenges
24:30
definitely exist time resources training
24:33
the field is actively addressing these
24:35
through simplified tools like the PGA
24:37
rethinking clinic workflows training
24:40
teams and importantly leveraging
24:42
technology like tele medicine and mobile
24:44
health and critically the focus is
24:46
expanding needing to expand more to
24:48
ensure this comprehensive approach is
24:50
available equitably to the increasingly
24:52
diverse older adult populations we see
24:54
and also to finally recognize and
24:56
support the vital needs of the
24:57
caregivers who are truly partners in
24:59
this journey yeah this article makes it
25:01
really clear that the future of cancer
25:03
care for older adults has to be holistic
25:05
it has to be personalized and it has to
25:07
recognize the unique strengths and
25:09
challenges of each individual and their
25:11
support system so as you our listener
25:14
reflect on all of this maybe consider
25:16
this given the really clear evidence
25:18
that geriatric assessment and management
25:20
significantly improves outcomes for
25:22
older adults with cancer and the fact
25:24
that implementation is still challenging
25:27
what do you think is the single most
25:28
important step needed right now to
25:30
ensure this comprehensive care reaches
25:32
everyone who could benefit regardless of
25:34
who they are where they live something
25:36
to think about
26:06
[Music]
#Aging & Geriatrics
#Health Conditions
#Cancer