Discussing Overall Prognosis with the Very Elderly

Division of Geriatrics, Department of Medicine, University of California, San Francisco, USA.
New England Journal of Medicine (Impact Factor: 55.87). 12/2011; 365(23):2149-51. DOI: 10.1056/NEJMp1109990
Source: PubMed


Though life expectancy inexorably decreases with advancing age, we tend to avoid discussing overall prognosis with elderly patients who have no dominant terminal illness. But we may thereby undercut patients' ability to make informed choices about their future.

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    • "However the number of studies is limited and concerns younger patients in a different setting. Our study focuses on settings that offer an opportunity for discussion on ‘modification of targets for chronic disease management’ and ‘reducing burden of medication’ or ‘life choices’ [21]. Patients as well as caregivers indicated that they would use a shared decision making instrument in clinical encounters and attributed multiple functions to the instrument, especially as a tool to facilitate agreement on treatment goals and plans [24]. "
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