Are older patients left out of healthcare decision making?
Sept. 7, 2001 -- The past decade has seen a revolution in access to medical information, and as a result, more and more people actively participate in making decisions about their own healthcare. But while the doctor-patient relationship may be evolving for most, a new study suggests little has changed for the elderly.
Researchers in the United Kingdom found that physicians often failed to give their older cardiac patients adequate medical information, and few elderly patients were actively involved in helping their doctors make treatment decisions. While many of the elderly patients surveyed said they preferred that their doctors make such decisions, they also expressed frustration at not being given good information about their condition. The study was published in the latest issue of the journal Quality in Health Care.
"Several of the patients we talked to felt they had been discriminated against because of their age, either by not being given enough information or by not being offered certain treatments," lead researcher Catherine Kennelly tells WebMD. "One woman in her 70s said doctors asked her family members about her quality of life and health status and never addressed questions directly to her. She didn't understand why they didn't ask her."
The study included 38 elderly people who were receiving treatment for coronary artery disease. The patients were asked about their understanding of risk, their treatment preferences, and the impact of different treatment on their quality of life.
Even though older patients tended to defer to their doctors, they were not necessarily happy with their treatments, Kennelly said. She added that the findings highlight the need for a "change in culture," in which physicians do a better job of educating elderly patients and patients see themselves as active participants in their care.
American Geriatrics Society president Kenneth Brummel-Smith, MD, says the U.K. findings do not necessarily hold true for elderly patients in the U.S., where generalizations about behavior are difficult.
"There is a wider diversity in old age than in any other age group," he says. "It is true that, in general, this age group comes from a generation that viewed their physicians as authority figures. On the other hand, Americans have a history of independence and tend to be more demanding."
Older people in the U.S. also access medical information through the Internet in greater numbers than ever before. Brummel-Smith noted that people over 65 are the fastest growing demographic for Internet use.
"Even when an elderly patient may be too frail to ask a lot of questions, what usually happens is that you have a family member who gets involved," he said. "In my experience it is usually daughters who come in with information they have gotten off the Internet."