Why is it so difficult to treat the elderly?
The decision to treat—or not treat—an older patient may be difficult; aging is highly individualized so treatment decisions cannot be made on the basis of age alone. And because the elderly are under-represented in clinical trials, information about how to best treat an older population is limited.
Is age irrelevant in treatment decisions for the elderly?
Age alone is no longer considered a reason to deny necessary care. It is widely assumed that equity demands that the elderly be treated like everyone else; that is, age has become irrelevant in treatment decisions.
How many elderly people will need health care?
Most of those 79 million elders will need health care at some point. Already, though people over 65 are 15 percent of today’s population, they account for 39 percent of hospitalizations. The medical establishment should recognize that older patients offer valuable lessons to practitioners.
Does age matter when it comes to cancer treatment?
Even when you are healthy, your body will most likely respond differently to treatment than a younger person’s body. For example, older adults are more likely to have serious side effects from chemotherapy. But age should not be the only factor in your treatment decisions.
How often should an 80 year old go to the doctor?
For most older adults, though, it's a good idea to have at least one medical checkup a year. At that visit, a provider can review medications, check on health concerns, talk about lifestyle topics and go over recommended tests.
What are the five reason for the elderly people need more care?
Health issues like blood pressure, heart failure, diabetes, arthritis among so many others are sicknesses older people might be exposed to if they are not properly cared for.
What age is considered medically elderly?
65 years or moreAgeing, an inevitable process, is commonly measured by chronological age and, as a convention, a person aged 65 years or more is often referred to as 'elderly'. 12,13 However, the ageing process is not uniform across the population due to differences in genetics, lifestyle, and overall health.
Do older adults need higher doses?
In most cases, older adults need lower doses of medications than younger adults. You can start with a low dose of a medication then slowly increase to the target amount to receive the same benefit and avoid side effects. This can be done by working closely with your healthcare provider.
What are the four major old age problems?
The four major old age problems include:Physical problems.Cognitive problems.Emotional problems.Social problems.
What age brings the greatest number of health problems?
In addition to heart and bone problems faced by 70-somethings, people in their 80s are at a higher risk for falls, cardiovascular disease, high blood pressure, diabetes, hearing and vision loss, dizziness, muscle weakness, a weaker immune system, and bladder problems or other urologic changes, according to Front Public ...
At what age does health start to decline?
Researchers with Duke University's School of Medicine suggest that physical decline begins in the decade of the 50s and worsens as we age, especially for those who don't exercise.
At what age does the brain decline?
As you enter midlife, your brain changes in understated but measurable ways. The brain's overall size begins to shrink when you're in your 30s or 40s, and the rate of shrinkage increases once you reach age 60.
Is 75 years old considered elderly?
Typically, the elderly has been defined as the chronological age of 65 or older. People from 65 to 74 years old are usually considered early elderly, while those over 75 years old are referred to as late elderly.
How many medications does the average 70 year old take?
Research shows that the average older adult takes four or more prescription drugs each day, but a whopping 39 percent of seniors take five or more prescriptions each day. While each one was created to treat or manage a specific medical problem, each also comes with its own risks and side effects.
What is the most common medication problem in the elderly?
Drug-related problems are common in older adults and include drug ineffectiveness, adverse drug effects, overdosage, underdosage, inappropriate treatment, inadequate monitoring, nonadherence, and drug interactions. (See also Overview of Drug Therapy in Older Adults.
What are the symptoms of being overmedicated?
Recognize the Warning Signs: Knowing symptoms to watch for can help you determine if your loved one may be overmedicated. Potential signs include: drowsiness; physical complications, like dry mouth and ulcers; confusion; withdrawal from family or friends; hallucinations; dizziness or falls; fractures; and seizures.
What is the starting point of treatment decisions?
This decision-making can be an ethical dilemma; however, the starting point is considering the patient’s wishes after providing accurate information about risks and benefits of treatment.
How many people are 80 and older?
According to the Census Bureau, 5.7 million people in the United States are aged 80-84 and 5.5 million are aged 85 and older. People are now living longer than ever before. In fact, the Hallmark Cards Company sells 85,000 “Happy 100th Birthday!” cards each year.
Is it difficult to suggest no treatment?
It appears it is just too difficult to suggest no treatment . The hesitation may be that no treatment is equated to “doing nothing,” which is not the case. When clinicians are fully informed about and comfortable with the principles of palliative care, there is much that can be done in the absence of cancer treatment.
Is cancer a problem for older people?
The numbers are growing, and with increasing age, come increasing medical problems. It’s not uncommon for an older patient to have heart disease, diabetes, arthri tis, and other medical disorders in addition to cancer.
Why are elderly people more likely to have more than one doctor?
Over treatment is a persistent problem among the aging population. Elderly people commonly have multiple medical issues and therefore are more likely to have more than one doctor involved in their medical care. Research shows that the more doctors an individual has, the more likely they are to be prescribed conflicting medications and undergo unnecessary procedures. The problem is that, for elderly people, unnecessary tests and surgeries can have dire consequences.
How to prevent unnecessary medical treatment?
The best way to prevent a loved one (or yourself) from receiving unnecessary medical treatments is to have an honest dialogue with the doctor. Above all, don’t be afraid to ask questions about a physician’s recommendations or seek a second opinion.
Why is it important to communicate with medical professionals?
Fostering open communication with medical professionals is crucial for avoiding unnecessary health care and costs. The following questions can help patients decide whether a particular test, procedure or medication is necessary.
Can you feed someone with dementia?
For people with severe dementia who can no longer eat on their own, percutaneous feeding tube s are sometimes recommended to ensure adequate nutrition and avoid aspiration. However, the AGS, the AMDA and the American Academy of Hospice and Palliative Medicine (AAHPM) all caution against the insertion of feeding tubes for patients in the later stages of dementia. Instead, they suggest oral assisted feedings as the preferable option. “Contrary to what many people think, tube feeding does not ensure the patient’s comfort or reduce suffering; it may cause fluid overload, diarrhea, abdominal pain, local complications, less human interaction and may increase the risk of aspiration,” according to the AMDA.
Can dementia cause dizziness?
Medical professionals and elder care experts have hotly debated the effectiveness of these drugs, trying to tease out the specific benefits for people with dementia and weigh them against the side effects, which can include confusion, incontinence, dizziness and even an increased risk of sudden death.
Is every medical procedure a risk?
Every medical procedure, no matter how innocuous, comes with risks. Understanding possible complications, their likelihood and their effect on a senior’s health is essential to making an informed decision about a test or procedure.
Can you take Seroquel with dementia?
Both the AGS and the AMDA advise that antipsychotic medications, such as quetiapine (Seroquel), risperidone (Risperdal) and olanzapine (Zyprexa), should not be given to people with dementia unless other nonpharmacologic methods of managing anxiety and dementia-related behaviors have already been attempted. “Antipsychotic medicines are often prescribed, but they provide limited benefit and can cause serious harm,” says the AGS in a statement. The effectiveness of these prescriptions vary, depending on the individual and the type of dementia they have. Medical professionals and elder care experts have hotly debated the effectiveness of these drugs, trying to tease out the specific benefits for people with dementia and weigh them against the side effects, which can include confusion, incontinence, dizziness and even an increased risk of sudden death.
When did Medicare start?
If that is not enough of a dilemma, consider the fact that Congress has resolutely refused, since Medicare’s initiation in 1965, to allow actual costs to be taken into account when determining the medical benefits the program will provide. “Reasonable and necessary” has been the only acceptable standard.
What will happen to the baby boomers when they retire?
As the baby boomers retire, that ratio will decline to 2.5 younger workers for every retiree. To keep the Medicare program at its present level of benefits would require a tax increase for the young of a magnitude that would threaten their ability to care for their families and children [3].
Can we deal with Medicare cost problem separately from overall costs of our health care system?
The third question is a matter of broad health care policy: can we deal with the Medicare cost problem separately from the overall costs of our health care system? The answer is no, a point agreed upon by every health policy expert [4]. The costs of Medicare are, in great part, caused by the cost of overall health care in this country—and Medicare’s coverage benefits affect those overall costs. The reason for this symbiotic relationship is simply that Medicare finances coverage benefits, but it is the private sector that mainly provides the actual care.
Is age considered a reason to deny care?
That has changed. Age alone is no longer considered a reason to deny necessary care. It is widely assumed that equity demands that the elderly be treated like everyone else; that is, age has become irrelevant in treatment decisions.
Can the elderly continue to work?
No doubt more of the elderly can continue to work and thus be less dependent, but there are likely limits to how far that can be pushed. There are some, like me at age 77, who continue to work, but the numbers drop off rapidly by 80 (and of course those who do hard manual labor rarely continue into their 70s).
Is age irrelevant in Medicare?
Unfortunately that last sentence must be qualified in light of Medicare’s financial situation. Under the best of circumstances, age should be irrelevant in the Medicare program. But so far, cost of care has not been considered, and it can hardly remain irrelevant in a program strapped for money; cuts will have to be made. There are a number of ways the program can put off making cuts that would directly limit the medical care of individual beneficiaries.
Why your decisions matter
In the past, doctors sometimes made decisions without talking with patients. Today, the situation is different. Your health care team wants to know your concerns and answer your questions. They also believe that you have the right to make your own decisions.
What to consider
Before making any treatment decisions, talk with your health care team about:
Your cancer treatment goals
Your cancer treatment goals depend on many factors. For example, the type of cancer and whether it has spread will factor into your goals.
If you and your family do not agree
Family members, friends, and caregivers might have different ideas about your treatment. They might want you to have more aggressive treatment. Or they might try to keep you from having certain treatments.
Cancer treatment options for older adults
You may have just one type of treatment or a combination of treatments. The main cancer treatments for people of all ages are:
Advanced cancer care
Advanced cancer is cancer that doctors cannot cure. It is also called end-stage cancer or terminal cancer. Even though your health care team cannot cure advanced cancer, they can treat it. And you can still have a good quality of life.
Questions to ask the health care team
After you learn about your treatment options and your general health, you might need more information. Consider asking your health care team the following:
Why is the elderly's right to health care restricted?
To claim that the elderly's right to health care must be restricted because they have achieved a "natural life span" -- that they have no life goals or possibilities -- is simply erroneous. In fact, their major life achievements may still be ahead of them. The right to health care does not diminish with age.
What happens if we treat the young one way and the old another way?
If we treat the young one way and the old another way, over time, each person is treated the same. Thus, a health care policy that treats the young and old differently will, over time, treat people equally. The arguments presented by the advocates of health care rationing provoke strong disagreement.
How much does the government spend on elderly people?
Advocates of health care rationing also argue that issues of justice are at stake in this social debate. It's estimated that the government now spends more than $9000 per elderly person and less than $900 per child each year. The skewed distribution of health care resources, they say, is not only detrimental to the overall health of the society; it is also unjust, because the elderly receive a disproportionately large piece of the health care pie, while a far greater number of younger people are deprived of an equal share of the nation's health care resources. Moreover, "need" should not be a fundamental criterion for determining how much health care the elderly (or others) are allotted. In the context of constant technological innovations to prolong life at all costs, the "needs" of the elderly know no bounds and drain the pool of resources that ought to be made available to all age groups.
What are the arguments for rationing health care?
The arguments presented by the advocates of health care rationing provoke strong disagreement . The claim that rationing would bring about the greatest balance of benefits for society is disputed by those who argue that any rationing policy depriving the aged of live-saving medical care would result in enormous costs and few benefits.
Why do people oppose rationing health care?
Others who oppose rationing health care on the basis of age argue that a mere consideration of benefits and costs fails to give due weight to other more important moral considerations, such as justice and rights.
What will happen to the health care system as technology advances?
As medical technology continues to advance, the ranks of the old and the very old continue to grow, the costs of health care continue to increase , and the competition for scarce health care resources grows ever more intense, our society will be forced to confront the issue of health care rationing, or at least the problem of equitable distribution of limited health care resources. The strategies that we adopt in trying to balance the needs of a changing population to the supply of resources may establish important precedents with implications reaching far beyond the health care field.
Is it unjust to spend more on the elderly than on the young?
Similarly, it is not unjust to spend more medical dollars on the aged than on the young, so long as every individual has the same access to medical care over a lifetime. Those who oppose rationing health care by age argue that such a policy would violate our moral sense of respect for persons.
When incapacitated patients have no advance directive, it becomes their duty to find a person to speak for them?
In some states, this is dictated by a rigid hierarchy; however, in my experience, it is not always the spouse or adult child who can best represent the patient’s interests. In most places, there is more latitude in determining who should speak for the patient.
Is medical decision making complicated?
Medical decision-making can be very complicated. With so many options and high-tech interventions , it’s no wonder patients and their families can become overwhelmed and bewildered when faced with choices in light of serious illness. Our job, and really our sacred duty, is to help patients and families understand not just the options being presented but also their probable benefits and burdens in the context of their current medical condition, their prognosis, and their lifelong values and goals. This is what advance care planning is all about.
Do you have to revise advance directives?
Those who do create an advance directive often do not review and revise it periodically as is recommended, particularly for the “5 Ds”: Death, Decade, Divorce, Diagnosis, or Decline.
Do people want to make medical decisions?
Most people would want a family member who knows them well to make medical decisions on their behalf, even if they have not designated a person and have not specifically expressed their wishes. Additionally, most people’s wishes as to what medical interventions they would want change over time. But because most healthy young individuals would want aggressive attempts to resuscitate them, that is the default. So our system assumes everyone — no matter how frail, ill, or old they are — wants cardiopulmonary resuscitation, defibrillation, intubation, ventilation, enteral feeding, and so forth.
Can a family member change a request for resuscitative measures?
This proposed law would make it impossible for a family member to change a person’s previous request regarding resuscitative measures, completed when the person had capacity, without a court order unless the family member was named in an advance directive. So, for example, Mrs. J, a healthy 70-year-old comes into a nursing facility for short-term rehabilitation after a hip replacement. She is asked to complete a POLST or other preferred intensity of treatment document, and she says, “Yes, I would want CPR.” (Note that according to the National POLST Paradigm, POLST (COLST, MOLST, POST, etc.) are designed for the chronically ill population, whose health care professionals would not be surprised if they died in the next year. We should not be doing POLST Paradigm forms on healthy, full-code nursing home admissions.) In any event, this document signed by the patient with decisional capacity is now part of her medical record.
What percentage of people 65 and older need a geriatrician?
The American Geriatrics Society estimates that 30 percent of people 65 and older need care from a geriatrician — a primary care physician with advanced training in the care of older people. But these doctors are in short supply.
What is the difference between older adults and younger patients?
Compared with younger patients, older adults were less involved in their own health care decision-making and doctors were less tolerant, less respectful and less optimistic.
How does ageism affect health care?
Ageism “permeates the attitudes of medical providers, the mindset of older patients, and the structure of the health care system, having a potentially profound influence on the type and amount of care offered, requested, and received,” according to research by geriatricians Karin Ouchida and Mark Lachs for the American Society on Aging.
How many people need a geriatrician?
The American Geriatrics Society estimates that 30 percent of people 65 and older need care from a geriatrician — a primary care physician ...
What are the causes of death for seniors?
Yet medication-related problems are estimated to be one of the top five causes of death in those 65 and older, and a major cause of confusion, depression, falls, disability and loss of independence. One in three seniors who take five or more medications will have at least one bad drug reaction each year; two-thirds will require medical attention. And those over 65 are 2.5 times more likely to visit an emergency room for an adverse drug reaction than younger individuals.
How many times more likely are people over 65 to go to the emergency room?
And those over 65 are 2.5 times more likely to visit an emergency room for an adverse drug reaction than younger individuals. Such deep-seated failings in the delivery of medicine to elderly patients are indicative of a larger problem in health care: ageism.
Why are older patients not in medical school?
One root cause is the lack of medical training to attend to the special demands of older patients. Medical schools routinely offer rotations in specialties like pediatrics, cardiology, surgery and emergency medicine. But geriatrics? Often not on the list.
Which vaccines are recommended for adults age 65 and older?
Check this easy to read vaccine schedule - PDF (PDF - 148KB) from the Centers for Disease Control and Prevention to find out which vaccines are recommended for adults age 65 and older.
Does Medicare cover vaccines for older adults?
Medicare Part B covers vaccines that protect against the flu and pneumococcal disease — and the hepatitis B vaccine if you’re at increased risk for hepatitis B. It also covers vaccines that you might need after an injury (like the tetanus vaccine) or coming into contact with a disease (like the rabies vaccine).
Find out which vaccines you need
CDC’s Adult Vaccine Quiz helps you create a list of vaccines you may need based on your age, health conditions, and more.
Get vaccinated
Getting vaccinated is easy. Vaccines are available at the doctor’s office and many pharmacies — and most are covered by insurance.
