A recent article in the New England Journal of Medicine suggests a seriously ill senior's decision to have surgery must balance the advantages and disadvantages of surgical and non-surgical treatment as well as the patient's value and goals in a team-based setting.
When a surgery decision is being made for a high-risk senior, the patient, his or her family, the surgeon, the primary care physician and the physician anesthesiologist all need to be involved, according to the article.
One-third of older Americans have surgery in the last 12 months of their lives, most within the last month. Yet, 75 percent of seriously ill senior patients say they would not choose surgery if they knew they would have severe cognitive or functional complications afterward.
The article suggests high-risk senior patients should be given the choice among treatments, including not receiving treatment, and the information they need to understand the potential benefits of each option, the likelihood of a good outcome and the risk of complications.
"These decisions should be driven by the patient's values and preferences. For some patients, autonomy and quality of life may be much more important than quantity of life," said Laurent G. Glance, MD, professor and vice-chair for research in the department of anesthesiology at the University of Rochester School of Medicine, in the article.
More Articles on Patient-Centered Care:
National Poll: Older Patients Want Coordinated Care From a Team of Providers
Patient Safety Tool: Advancing Effective Communication, Cultural Competence and Patient- and Family-Centered Care With The Joint Commission