A new comprehensive report suggests that many elderly patients are receiving treatments that don't meet the requisites of established guidelines and often times fail to adhere to personal healthcare goals and preferences of the patient. The study comes from the Dartmouth Atlas Project.
The study identifies five practices that are shortchanging seniors.
1. Screening for prostate cancer in men 75 and older: While administering a blood test to check for prostate cancer is a simple and noninvasive procedure on its own, a positive cancer screening can trigger a tedium of testing. These additional tests can harm elderly patients already in a fragile state of health.
2. Performing mammograms on women 75 and older: Recent research suggests that breast cancer screening with mammography is only having a small effect on breast cancer-related mortality. When deciding to screen in elderly women over the age of 75, consideration must be given to the likelihood of a life expectancy of 5 to 10 years in the patient.
3. Late hospice referral at end of life: The study found in 2012, 17 percent of Medicare beneficiaries were enrolled in hospice only during the last three days of life. This is not reflective of patient's preferences that often prioritize comfort measures over medical intervention.
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4. Administering feeding tubes in dementia patients: In 2012, 6 percent of dementia patients were administered feeding tubes in their final six months. The practice does not prolong life in these patients who eventually lose the ability to swallow and the desire for food in the terminal stages of the disease.
5. Time spent in intensive care unit in last six months of life: The average amount of days spent in the ICU during the last six months of life is trending upward. While in the final stages of their lives, patients often place a premium on comfort. The priority of physicians and nurses is largely to keep said patient alive, according Kaiser Health News. This disparity in priorities highlights the importance of open communication between physicians, patients and the patients' family. Julie Bynum, MD, an associate professor at the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, N.H., said in the KHN article examining the study, "Where there are harms and benefits and people judge them differently, that's where the shared decision-making comes in."
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