Counseling & Support: Help for Older Patients

Pictured: Beatriz Korc-Grodzicki Geriatrics Service Chief Beatriz Korc-Grodzicki (left) and social worker Margery Davis are part of a multidisciplinary team that can help with the unique challenges of having cancer after age 65.

A diagnosis of cancer is difficult at any age, but older patients face unique challenges. Older adults and their caregivers have special needs and considerations, including increased risk of drug reactions, the presence of additional health conditions, increased financial burdens of care, and caregiver stress and strain. Memorial Sloan Kettering Cancer Center is committed to providing cancer patients aged 65 and older with the treatment, facilities, and support they need.

With this goal in mind, Memorial Sloan Kettering offers the services of a multidisciplinary geriatric team through the 65+ Program. This team includes oncologists, geriatricians (physicians who specialize in the care of older adults), a geriatric nurse practitioner, nurses, social workers, a geriatric nutritionist, psychiatrists, a geriatric pharmacist, and members of the Palliative Medicine Service, Rehabilitation Department, and Integrative Medicine Service.

Geriatrics Service

The Geriatrics Service offers medical consultations with geriatrics specialists during the treatment of older patients with cancer. Older patients often have health conditions in addition to their cancer that require special attention and extra care. Such patients may be receiving treatment from multiple physicians and need someone to provide a comprehensive evaluation so they are not put at risk for avoidable complications. Geriatricians are trained to look for subtleties in the way older patients respond to treatments and to perceive symptoms of medical illnesses that are common in these patients.

Our geriatric physicians and geriatric nurse practitioner consult with Memorial Sloan Kettering oncologists to help them determine how well a patient may tolerate a specific cancer therapy, and what precautions may need to be taken during treatment due to advanced age. Members of the service also see patients who have finished their cancer treatments but still need follow-up care.

The Geriatrics Service is available, on referral, to both Memorial Sloan Kettering inpatients and outpatients. Patients who would like a geriatric specialist involved in their care should ask their Memorial Sloan Kettering doctor or nurse for a referral to the service.

Our Geriatricians

Geriatric Medication Management

The geriatric medication management clinic provides pharmaceutical care to meet the medication needs of older patients. The clinical pharmacist will evaluate an individual patient's medication needs, simplifying the regimens and ensuring that prescribed medications are taken according to physician instructions and are as appropriate, effective, and safe as possible. The goal is to ensure that patients' medication regimens are not interfering with the goals of therapy or contributing to excessive disability, loss of independence, or decreased quality of life.

All Memorial Sloan Kettering patients, regardless of whether they are under care of the Geriatrics Service, can contact the geriatric clinical pharmacist at 212-639-7489. Patients who have questions or concerns about medication may call the geriatric pharmacist directly or ask their oncologist about the service. For more information about geriatric medication management, please call 212-639-7489 or speak to your Memorial Sloan Kettering doctor.

65+ Social Work Program

Our 65+ Social Work Program offers psychosocial counseling and support that seeks to improve each participating patient's quality of life. To do this, our social workers help older patients adjust to the difficulties associated with illness and assist them as they cope with the effects of the normal process of aging. In addition to health conditions such as diabetes and high blood pressure, older patients may be at an increased risk of social isolation due to circumstances such as living alone or acting as the primary caregiver for a spouse. Our social workers provide supportive counseling, cognitive and behavioral strategies, and problem-solving techniques through individual, couple, and family sessions.

Those who may benefit from the 65+ Social Work Program's services include older patients who are living alone or who do not have other available means of support; patients who may be experiencing some measure of psychological distress, such as depression or anxiety; and adult children who are caring for older cancer patients. For more information about the services of the 65+ Social Work Program, Memorial Sloan Kettering patients can contact the 65+ Program at 646-888-4741 or 65plus@mskcc.org, or speak to their Memorial Sloan Kettering doctor or nurse.

In addition, the 65+ Social Work Program provides consultations and information on aging and cancer-related issues to patients, caregivers, staff, and the Memorial Sloan Kettering community through monthly educational lectures, an annual health fair, and supportive seminars. Topics discussed at our 65+ Educational Lecture Series include exercise, cancer and the older patient, and spirituality.

Rehabilitation for 65+ Patients

The 65+ Rehabilitation Program has on staff an occupational therapist and a physical therapist who specialize in treating older patients at Memorial Sloan Kettering. The therapists' combined goals are to maintain and improve the ability of patients to move and function normally as they prepare to leave the hospital.

Video

As an outpatient physical therapist at Memorial Sloan Kettering Cancer Center, Sebi Varghese is at the forefront of developing creative new approaches to rehabilitation for cancer patients. Varghese and her team use a variety of methods to help patients restore range of motion, reduce pain, increase energy, and become active participants in their recovery. Taking part in someone's recovery — and hopefully opening up a new chapter in his or her life — is very satisfying, she says.

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Our occupational therapist addresses basic activities of daily living, such as dressing, grooming, toileting, and bathing, as well as instrumental activities of daily living, including handling finances, managing medications, and shopping. The therapist also evaluates and treats cognitive changes, such as memory, attention, and vision, and helps patients maintain their independence through environmental modifications, compensatory strategies, and procedures that optimize safety.

Our physical therapist helps enable patients with a variety of musculoskeletal, neuromuscular, and cardio-pulmonary issues to achieve the highest possible level of functional independence. The therapist evaluates each patient and designs an individualized treatment plan that will help restore and maintain movement needed for everyday life, diminish pain, increase endurance, and enhance safety awareness. The therapist and patient work closely together to ensure that the patient's personal goals are part of the treatment plan.

Memorial Sloan Kettering patients who want to learn more about the 65+ Rehabilitation Program may call the 65+ Program at 646-888-4741 or speak to their Memorial Sloan Kettering doctor. For more information on general rehabilitation services at Memorial Sloan Kettering, please visit the Rehabilitation section.

Palliative Medicine Services

The Palliative Medicine Service for older adults supports Memorial Sloan Kettering patients aged 65 years and older who have chronic pain or other uncomfortable symptoms related to cancer and its treatment, especially during the advanced stage of disease. The focus of this palliative care service is to relieve the pain and suffering of patients while they are receiving other appropriate treatments and to offer support to their loved ones. Palliative care addresses physical symptoms such as pain, shortness of breath, and nausea, but also non-physical causes of suffering, such as sadness and depression over impaired function and anxiety regarding treatment choices and end-of-life decisions.

A geriatrician and geriatric nurse practitioner provide comprehensive symptom management, psychosocial and spiritual support, and care that is sensitive to the specific needs of patients and their families. The service routinely collaborates with the Rehabilitation Department, the Pain Service in the Department of Anesthesiology, the Integrative Medicine Service, the Department of Psychiatry and Behavioral Sciences, Chaplaincy Services, and the Social Work Department.

Members of the Palliative Medicine Service work alongside the oncologists who are treating the cancer to ease distress, especially during the end of life, and to assist with advanced care planning. This is done both on the inpatient and outpatient units and in collaboration with various home-care agencies and hospices to make transitional care as seamless and supportive as possible.

For more information about our Palliative Medicine Service, you can call the 65+ Program at 646-888-4741, visit the Pain and Palliative Care section, or speak to your Memorial Sloan Kettering doctor.

Our Pain and Palliative Care Physician

Geriatric Psychiatry Program

When an older adult gets cancer, the diagnosis sometimes coincides with other physical, psychological, and social losses that are taking place. These losses may include diminished sight, hearing, and mobility. At the same time, the loss of family members and friends begins to occur more frequently, and retirement may change an individual's financial security.

The Geriatric Psychiatry Program within the Department of Psychiatry and Behavioral Sciences provides psychosocial support during treatment and addresses the continuing needs of patients. Our counselors are available to patients during their hospital stay as well as on an outpatient basis. They also are available to cancer patients and their caregivers even if they were not treated at Memorial Sloan Kettering. In addition, our counselors can provide referrals to other mental health specialists &mdash both within Memorial Sloan Kettering and externally &mdash to assist in longer-term counseling needs.

Our counselors are experienced in identifying various sources of distress, which are often associated with diagnosis, disease recurrence, non-response to cancer treatment, side effects from cancer treatments, and the changes that occur with a cancer diagnosis later in life. Counseling is open to individuals, couples, or families. Additionally, group sessions are available for patients or family members who might benefit from working with others in similar circumstances. Our psychiatrists can also prescribe medication when needed to address more severe forms of anxiety and depression.

Our Counselors

For more information about the Geriatric Psychiatry Program, or to request an appointment for a consultation, please call 646-888-0200.

Our Location

Memorial Sloan Kettering Counseling Center
641 Lexington Avenue, 7th Floor
(On 54th Street between Third and Lexington Avenues)
New York, NY 10022

Nutrition for 65+ Patients

Nutrition plays an integral role in many aspects of cancer care, including symptom management and recovery. Older adults may be at risk for vitamin and mineral deficiencies that affect nutrition status and warrant therapeutic restrictions and medical nutrition therapy.

The cost-free services of the 65+ Program's outpatient dietitian are available to all Memorial Sloan Kettering outpatients. The services include initial nutrition counseling, nutrition education, and follow-up assessments. Patients are most often counseled on weight management, diabetes education, symptom management, and special diets.

Nutrition counseling sessions — which may be conducted in person or via a phone consult — provide a review of a patient's diet history, which includes a discussion of how often the patient eats, changes in weight and appetite, supplement use, and side effects of treatment. Nutrition education covers both regular and special diet restrictions. Additionally, patients learn about managing symptoms related to cancer and its treatment, such as weight gain/loss, loss of appetite, and the safety and usefulness of dietary supplements. Follow-up assessments provide feedback on nutrition status and progress toward nutrition goals as a result of the counseling and education.

Memorial Sloan Kettering patients who want more information about nutrition for 65+ patients or wish to schedule an appointment can call 212-639-7071 or speak with their doctor or nurse.

Complementary Therapies

Integrative medicine supplements mainstream cancer treatments with complementary therapies, many of which are ancient healing methods, to help control physical and emotional symptoms and speed recovery. For people living with chronic or life-threatening illness — as well as those who are not ill — it can significantly improve the physical, emotional, and spiritual dimensions of their lives.

The Integrative Medicine Service at Memorial Sloan Kettering was established in 1999 to complement mainstream medical care, alleviate symptoms of cancer, and improve quality of life for patients and families. The service offers touch therapies; mind-body therapies; acupuncture; creative therapies, such as music therapy; nutrition counseling; exercise programs to improve strength and endurance and promote relaxation; and educational programs for patients, caregivers, and healthcare professionals.

Fee-for-service therapies provided at the Bendheim Integrative Medicine Center (Corner of First Avenue and 74th Street) and therapies provided at no charge in the inpatient setting can help alleviate stress and anxiety, increase self awareness, enhance well-being, and help prevent health-related problems.

Services at the Bendheim Integrative Medicine Center are available to all cancer outpatients, whether treated at Memorial Sloan Kettering or elsewhere. The Integrative Medicine Service takes referrals from oncologists at other hospitals and in private practice.

For more information about these therapies or to make an appointment, please call 646-888-0800 or visit the Integrative Medicine section.

65+ Newsletters

Support for Our Programs

Generous contibutions from the Joachim Silbermann family have supported Memorial Sloan Kettering's programs for the older cancer patients. Read more about their commitment.