• Catherine J Evans, Lucy Ison, Clare Ellis-Smith, Caroline Nicholson, Alessia Costa, Adejoke O Oluyase, Eve Namisango, Anna E Bone, Lisa Jane Brighton, Deokhee Yi, Sarah Combes, Sabrina Bajwah, Wei Gao, Richard Harding, Paul Ong, Irene J Higginson, and Matthew Maddocks.
• King's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation.
• Milbank Q. 2019 Mar 1; 97 (1): 113-175.

AbstractPolicy Points We identified two overarching classifications of integrated geriatric and palliative care to maximize older people's quality of life at the end of life. Both are oriented to person-centered care, but with differing emphasis on either function or symptoms and concerns. Policymakers should both improve access to palliative care beyond just the last months of life and increase geriatric care provision to maintain and optimize function. This would ensure that continuity and coordination for potentially complex care needs across the continuum of late life would be maintained, where the demarcation of boundaries between healthy aging and healthy dying become increasingly blurred. Our findings highlight the urgent need for health system change to improve end-of-life care as part of universal health coverage. The use of health services should be informed by the likelihood of benefits and intended outcomes rather than on prognosis.© 2019 The Authors The Milbank Quarterly published by Wiley Periodicals, Inc. on behalf of The Millbank Memorial Fund.

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