As the director of the intensive care unit at Memorial Sloan-Kettering Cancer Center in New York City, Jeff Groeger, MD, often cares for patients who have been told they have little time left to live.
Once the bad news sinks in, he must help them decide whether they should choose the most aggressive medical treatment available. "It stinks," he says -- meaning the emotional drain on both health care providers and loved ones.
You know the story: Somebody's 99-year-old aunt never exercised, smoked her whole life, and lived on a diet of red meat and ice cream. So why bother with healthy living, right?
"For every one person who lives a long life of unhealthy choices, there are countless others who die prematurely because of them," says Robert Schreiber, MD. He's a doctor at Hebrew SeniorLife, an affiliate of Harvard Medical School.
No one is guaranteed a healthy life. But following certain guidelines -- namely, eating...
It's also a complicated process. Everything from the patient's age, to the chances of surviving aggressive treatment, to his or her wishes for end-of-life care must be taken into account.
Such difficult decisions will become more commonplace. The number of aged in America is growing at an astounding pace, and controversy is building over how to treat those who are sick.
Some believe elderly patients should not be put through aggressive treatments because they are less likely to survive the heroic efforts. But others believe a bias against the elderly may lead to beneficial care being withheld.
Studying Survival Rates
Now a new study on the relationship between age, intensity of treatment and survival of serious illness has yielded some interesting findings. Researchers at five teaching hospitals across the country looked at 9,105 patients, aged 18 to 100, who were hospitalized with serious illnesses. They looked at the connection between age and the likelihood of survival six months later -- and especially at whether the intensity of the treatment affected the outcome. After six months, more than half the patients were still alive, according to Mary Beth Hamel, MPH, MD, the lead author of the study and a researcher at Beth Israel Deaconess Medical Center in Boston.
Not surprisingly, the older the patient, the more likely he or she was to die during the six-month follow-up period. What was surprising was that the difference in death rates was smaller than expected. A 55-year-old, for instance, had a 44% chance of dying in the follow-up period; an 85-year-old, 60%. How severe the patient's illness was turned out to have more to do with survival than age did.
Researchers say they cannot tell from the study why older patients did slightly worse overall than their younger counterparts. "People think that as you get older you have no hope of surviving a devastating illness," Hamel says. "That's just not the case."