Geriatric assessments are crucial to guiding decisions and improving outcomes in people aged 65 and older, who are at increased risk for frailty and multiple comorbidities, according to a poster presented at the 48th Annual Oncology Nursing Society (ONS) Congress.
A research team set out to incorporate a geriatric assessment into the oncology nurse navigator initial intake for people aged 65 and older with newly diagnosed cancer. They also planned to develop a consistent workflow for referrals based on the assessment and provide information to the oncologist that may help guide treatment decisions before the first consult.
The workups that the team devised included a screening tool to predict mortality. Known as the G8, this tool evaluates food intake, age, weight loss, mobility, body mass index, neuropsychological conditions, polypharmacy, and the patient’s own perception of their health status. They also incorporated the Cancer and Aging Research Group (CARG) to predict chemotherapy toxicity.
The workflows included:
- Standardized messaging to primary care providers to reduce polypharmacy
- Outreach to dietitians to improve nutrition
- Involvement of a social worker for patients who would benefit from completion of advanced directives and/or increased family support.
The researchers determined that it was easy to incorporate the geriatric assessment into the navigation intake. They also found the assessment provided a more complete picture of the patient to the oncologist, which helped in creating the best plan of care. The patients and caregivers also noted that the proactive referrals made them feel “cared for” and reduced their anxiety.
However, screening patients with dementia and those who did not speak English can be challenging.
The researchers concluded that nurse navigators play an important role as a patient advocate by identifying and addressing barriers to care. Early evaluation and proactive referrals can be a vital part of their role, one that improves the care received by older adults with cancer.
Dowling A, Jansen C, Tran C, Huang Y, Beringer K. Ensuring geriatric patient readiness for treatment. Poster presentation at: 48th Annual ONS Congress; April 26-30, 2023; San Antonio, TX.