The Impact of a Multimodal End-of-Life Care System in Geriatric Medicine on the Mental Health of Super Elderly Patients and Their Families: A Cohort Study

Objective To investigate the impact of a multimodal end-of-life care (MEC) model in geriatric medicine on the mental health of super elderly patients and their families. Methods A retrospective cohort study was conducted, including 68 super elderly patients and their primary caregivers who received services from a MEC system in the Department of Geriatrics of our hospital between January 2023 and June 2024 as the observation group (OG). A matched cohort of 68 patients and their caregivers receiving routine end-of-life care during the same period was selected as the control group (CG). Symptom burden scores (Edmonton Symptom Assessment System, ESAS), QOL (McGill Quality of Life Questionnaire), psychological status (HAM-A, HAM-D), well-being, and hope levels were compared between the 2 groups at baseline, after 2 weeks, and after 4 weeks of intervention. Results At both 2 and 4 weeks after intervention, patients in the OG exhibited significantly lower total ESAS scores, markedly higher overall QOL scores, and significantly reduced HAM-A and HAM-D scores compared to the CG ( P < .05). At week 4, patients in the OG demonstrated significantly higher scores on the SWLS, HHI, and MLQ compared to the CG ( P < .05). Additionally, after 4 weeks of intervention, family caregivers in the OG exhibited a significant reduction in caregiving burden and symptoms of anxiety and depression ( P < .05); end-of-life care of family caregivers was markedly higher than that of the CG ( P < .05). Positive coping strategies and psychological resilience scales scores of patients in the OG were higher than those in the CG, and negative coping strategies scores were lower than those in the CG ( P < .05). The overall incidence of adverse events was significantly lower in the OG than in the CG ( P < .05). Conclusion The MEC model in geriatric medicine alleviates symptom burden, enhances QOL, reduces caregiver burden, and minimizes the incidence of adverse events.