Triage and initial management of problems in elderly cancer patients are often handled by nursing personnel with the use of standard protocols. The nurse must be able to recognize the altered presentations of illness and side effects in the elderly as well as pharmacologic differences in the use of commonly prescribed drugs. Examples of enhanced side effects of drugs used in the elderly include increased risk of disorientation, light-headedness or falls from the use of antiemetics or opioids, and increased risk of dehydration from drugs that cause vomiting and diarrhea in elderly patients with decreased thirst response. The oncology nurse is a key provider in assessing and managing pain because of the prolonged contact with patients in a variety of settings. The oncology nurse is also on the front lines of managing nutritional support and other symptoms.
Many social issues arise in the care of elderly cancer patients.
These issues often become complex and require the expertise of a social worker or an interdisciplinary team. Services may have to be coordinated to help with home care, travel, meal preparation, and drug adherence. Counseling may be warranted to help patients and their families cope with the seriousness of the illness. Efforts to overcome these difficulties frequently require alterations in treatment plans and interdisciplinary approaches. Finances may pose problems as well.