Nursing care of elderly persons throughout the cancer experience. A quality of life framework

The geriatric oncology nurse integrating a sound theoretical knowledge base with the dimensions of time, an ethical framework, and an affirmative approach to aging reinforces older adults' constellation of personal strengths and coping resources and sustains the self-determination and integrity of patients throughout the cancer experience. Assisting older adults to accomplish life tasks while balancing illness demands with coping resources requires patience, flexibility, and sensitivity. Strategies are planned and implemented to assist older adults in achieving with equanimity biologic and psychosocial life tasks and maintaining a comfortable level of functioning consistent with the limitations imposed by the illness and aging processes. It is challenging for nurses to provide the best possible control of troublesome symptoms in an evolving illness with frequently changing needs and concerns. Adequate symptom management requires astute observation skills and coordination of care among other disciplines to achieve patient comfort and dignity. The patient's frame of reference regarding well-being and life quality is the major determinant in planning care. In this era of technological and scientific innovations, it is a nursing responsibility to explore quality of life as a realistic outcome variable for older adults throughout the cancer experience, including the time when death is imminent.