Doctors should be more upfront

An American doctor believes clinicians need to be “frank” and open with their elderly patients.

Dr Alexander Smith is hoping to provoke a national discussion about the need to outline the future health of an elderly patient – provided the patient wants to know.

According to the LA Times, studies show patients want to discuss the “realities of ageing”.

“But they may be waiting for the physician to bring it up,” Dr Smith adds.

The assistant professor of medicine at the University of California alleges it is often the doctor who does not want to talk about the ageing process with their patients.

“Despite knowing life expectancy inexorably decreases with advancing age, we tend to avoid discussing overall prognosis with elderly patients,” he says, adding by avoiding these discussions “we may undercut the ability of patients and their caregivers to make informed choices in the future”.

According to Dr Smith, when patients are aware of their options, they can often make choices themselves that reduce the cost of care.

“It is our job to support the patients’ goals and aspirations. Right now we are conducting a study to find out why patients will talk about a short-term prognosis but generally aren’t willing to talk about five or 10 years ahead.

“We need to set a balance but we also must give hope. So many are living longer comfortably with disabilities that once were painful.

“We need to start helping our very elderly patients set goals of care that take their overall prognosis into account. We should do so in the ordinary course of clinical practice and [allow] our patients be our guides.”

Are you a health profession? If so, how upfront are you with your patients? Share your thoughts by commenting in the box below.