Category: Healthcare Decisions

Study Finds that Most Older Adults are Aware of Medication Risks

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JAGS graphicJournal of the American Geriatrics Society Research Summary

Geriatrics experts know that certain medications may have risks for older adults that outweigh their benefits, especially when safer alternatives are available. Medications that could be “potentially inappropriate” for older adults are included on recommendation lists that your healthcare provider can consult, such as the American Geriatrics Society (AGS) Beers Criteria or the STOPP-START list.

However, despite these recommendations, 25 percent of older adults take at least one potentially inappropriate medication every year. Taking these medications can increase the risk of being hospitalized due to a medication-related problem. Although 70 percent of older adults are willing to stop taking certain medications, healthcare providers continue to prescribe some potentially inappropriate medicines to older adults.

Researchers from the Institut Universitaire de Gériatrie in Montréal, Canada, designed a survey to learn about older adults’ awareness of drug-related health risks. They conducted the survey over the telephone with 2,665 participants, aged 65 or older. Continue reading →

Talking to Older Adults About Health Prognosis May Be Helpful

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JAGS graphicJournal of the American Geriatrics Society Research Summary

Prognosis is the term for the most likely outcome of a medical condition. When it comes to health care, talking about your prognosis can be difficult for you, your family/friends, and even your healthcare providers. However, many of us prefer to talk to our healthcare providers about the expected course of an illness and about our life expectancy when living with a chronic or terminal illness.  This is according to new research on advanced care planning (the technical term for having early conversations with our healthcare providers about our care needs, preferences, and expectations).

In a new study published in the Journal of the American Geriatrics Society, researchers examined how older adults with disabilities later in life might react to learning their prognosis, and how they evaluated their own prognosis compared to “official” estimates.

The study participants were 35 adults 70-years-old and older from four geriatrics clinics in the San Francisco Bay area. All the participants required help with daily activities, and they all participated in a 45-minute interview as part of the study.

The researchers asked older adults questions about how they would want to receive information about their life expectancy. For example, did they prefer hearing or reading news about their prognosis? Would they prefer receiving information about their prognosis while at home by themselves? Continue reading →

Hospice Care Offers Comfort for Older Adults at End of Life. Should it be Considered Sooner?

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JAGS graphicJournal of the American Geriatrics Society Research Summary

A team of researchers from Yale University has studied how soon older adults who were experiencing distressing symptoms and disability were admitted to hospice near the end of their lives. Their study was published in the Journal of the American Geriatrics Society.

The researchers examined information from a study of 562 people, aged 70 and older, who were not disabled when the study began. Of these people, 244 (43.4 percent) were admitted to hospice during the last year of life. These people were slightly older and more likely to have cognitive impairments (problems thinking and making decisions) than those individuals who weren’t admitted to hospice.

The most common condition leading to death was frailty (the medical term for physical weakness or an increasing likelihood for poor health), followed by organ failure (the term for certain parts of our body no longer working as they should), advanced dementia, and cancer. Continue reading →

Hospitalized Older Adults Released to Skilled Nursing Facilities May Not Get Counseling to Help Make Informed Choices

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JAGS graphicJournal of the American Geriatrics Society Research Summary

More than 20 percent of all hospitalized older adults who use Medicare will be admitted to a skilled nursing facility following a stay in the hospital (also known as “post-acute care”). However, these men and women may be given too little information when it comes to choosing a post-acute care facility: sometimes they may receive just a list of addresses for local facilities. What’s more, hospitalized older adults typically don’t plan for care at a skilled nursing facility ahead of time. This can lead to making important decisions too quickly or during a time of particular stress.

We don’t have much information about how people select skilled nursing facilities or what information they’re given to make informed choices. So a team of researchers recently studied how hospitalized older adults make decisions about choosing a facility, who helps them decide, what they think about the process, and what they consider as they make decisions. The researchers published their study in the Journal of the American Geriatrics Society.

They interviewed 98 older adults who had just been admitted to a skilled nursing facility. In 90 interviews in five cities across the country, the researchers spoke only to the older adult. A family member participated in the other eight interviews. Continue reading →

Older Married Couples and Advance Directives

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JAGS graphicJournal of the American Geriatrics Society Research Summary

Advance directives (ADs) are legal documents you can use to state in advance what medical treatments you do or do not wish to have under certain circumstances. You also can use an AD to name one or more people to act on your behalf if you are ever unable or uncomfortable making your own healthcare decisions.

Studies have shown that, at the end of life, people who have ADs receive less aggressive life-sustaining treatment and are less likely to be admitted to intensive care units, sometimes because those may not be options an older person wants to pursue. They are also more likely to die at home instead of in a hospital, and they receive hospice care earlier and for longer periods of time.

About 50 percent of people 65 and older in the United States have completed ADs. However, little is known about why some people have them while others do not. Most research treats the decision to complete an AD as an individual choice, but we know little about the roles that spouses and other family members may play in a person’s decision to engage in end-of-life planning.

A new study examined the effects spouses had on the decision of older adults to have ADs. The study was published in the Journal of the American Geriatrics Society. Continue reading →