Elderly patients can play an active role in their care by asking questions about medications, dosages, and treatment options.
For years, Sarah Bevel’s doctors were able to effectively treat her heart and kidney ailments even in the 1990s. But when the only remaining Bevel ball began to fail, she decided to move to a hospital. The transition has been tough for Beville, who passed away this month at the age of 94. She was very active in her community in Dinwiddie, Virginia, and had been in regular contact with friends until a few weeks ago.
The growing number of elderly Americans living with chronic health conditions raises difficult questions about appropriate medical treatment for older adults. Some elderly patients receive powerful treatments that may cause more harm than good. Others may be treated because the risks of treatment may outweigh the potential benefits.
“Treating disease in the elderly is a real concern,” says Dr. Kerr. In a December 2015 study in JAMA Internal Medicine, Kerr and a team of researchers found that many elderly people with diabetes are treated more aggressively, which is a problem because not cutting back on their medications can lead to low blood sugar (hypoglycemia). In the blood) and put older patients at risk of falls, cognitive problems, and even death.
Kerr adds that many of the drugs that may be effective for younger adults, such as pain or high blood pressure medications, could be dangerous for older patients if used incorrectly.
Job age assessment
“The best medical decisions are personal,” says Artori Horea, an oncologist, director of the Cancer and Aging Research Program at the City of Hope Cancer Center in Duarte, California. Dr. HERIA states that cancer treatment decisions should be based on an assessment of the patient’s career age, which affects their health status, life expectancy, goals, personal values, and healthcare preferences.
Hurria has instituted an evaluation to help identify patients who may not respond well to chemotherapy. Horia led a study at several cancer centers to determine who was at risk and identified 11 predictive questions to help oncologists make individualized treatment recommendations.
Both Kerr and Hurria agree that patients should play an active role in making treatment decisions – a manager he knows as. When doctors suggest new treatments, tests, or drugs, patients must ask: How likely are they to benefit me? What are the specific side effects or negatives? Are there alternatives? Bevel’s son, Don says, says his mother always asked questions when she was unclear about her doctor’s recommendations.
Kerr notes that older patients regularly check in with their doctors whether they will continue to take the medications at the same doses. “Sometimes it’s okay to change [medications] when our body changes as we express age.” Kerr says medications needed for conditions like osteoporosis, depression and diabetes should be reassessed periodically.
Health literacy is the key
According to the Agency for Health Care Research and Quality (AHRQ), nearly a third of American adults, especially among the elderly, have limited knowledge of health issues, which is “the degree to which individuals can obtain and treat and understand basic health information.” And the services they need to make appropriate health decisions.
Regardless of a patient’s age, there are tools available to help them make informed treatment options. Known as decision aids, these tools are known between print materials, video demonstrations and the risk calculator. According to a 2015 report in the British Medical Journal (BMJ), more than 500 decision-making aids have been developed to date. Many are available on websites, such as the Mayo Clinic National Resource Center for Shared Decision Making.
Wisely Choice, an initiative of the American Board of Internal Medicine, provides specific evidence based on specific conditions to help patients and their loved ones discuss treatment options with their doctors. One of these resources, Treatments and Tests for Seniors, reviews medical information and advice on conditions common to older adults, such as dementia and chronic pain.