Usher Institute

Over 70s missing out on palliative and end of life care

Most people aged 70 and over in Scotland are missing out on palliative care as healthcare professionals can find it difficult to know when to introduce this approach in older people, according to a new report from the University of Edinburgh and terminal illness charity Marie Curie.

Published in the European Journal of Palliative Care ‘Why do older people get less palliative care than younger people?’ examines the end of life experiences of 65 patients in Scotland who were diagnosed with brain and bowel cancer, liver failure and frailty. The report concludes that more effort should be made to identify triggers for palliative care in older people.

Unaware, not considered relevant

The findings suggest that the introduction of a palliative care approach or referrals to palliative care services didn’t happen because many older people were not aware about this type of support.  Some healthcare professionals did not think it relevant. There were less clear signs which would have indicated a patient’s condition might soon deteriorate and that they would now benefit from palliative care.

Lack of clear diagnosis of dying in frail elderly

The study highlights there can be a lack of a clear diagnosis of dying as people in this age group are viewed merely as ‘old’ or ‘infirm’. Frailty, the most common condition of someone aged 70 or over in the study, is a terminal condition that many older people can develop and they would likely benefit from palliative care to improve their quality of life. For people with conditions other than cancer there is often an assumption that palliative and end of life care would not benefit them.

Age-related inequalities

The report authors conclude that further research is needed to understand age-related inequalities.

People need to know that palliative care has something to offer everyone so that they can live as well as possible wherever they are. It can prevent much unnecessary distress by helping people with whatever worries them most, whether they have cancer, heart failure or living with frailty.

Professor Scott MurrayUniversity of Edinburgh Primary Palliative Care Research Group and St Columba’s Chair of Primary Palliative Care


The research we have undertaken has highlighted the need to help healthcare professionals recognise when people may be helped regardless of diagnosis or age and how palliative care can support patients at all stages of many illnesses. Palliative care can be beneficial to people living with many conditions or illnesses whether they have months, weeks or days left. At St Columba’s Hospice our Centre for Education & Research already works closely with the NHS and other medical and healthcare providers to train practitioners and we are pleased to be contributing a solution that helps to alleviate this problem.

Dr Anna LloydResearch Fellow, St Columba's Hospice


The findings of this report will be discussed at a seminar in Edinburgh on 15 September.

‘Challenging Inequities in Palliative Care’ will also discuss barriers faced by those from lesbian, gay, bisexual and transgender communities, black, Asian and minority ethnic communities, people from deprived backgrounds and those living in social isolation. To book tickets email

Related links

Marie Curie

Primary Palliative Care Research Group, Usher Institute

Journal article

Anna Lloyd, Marilyn Kendall, Emma Carduff, Debbie Cavers, Barbara Kimbell and Scott A Murray. Funded by Marie Curie ‘Why do older people get less palliative care than younger people? European Journal Of Palliative Care, 2016; 23(3)