Talking to older adults about health prognosis may be helpful

September 15, 2017, American Geriatrics Society

Prognosis is the term for the most likely outcome of a medical condition. When it comes to health care, talking about your prognosis can be difficult for you, your family/friends, and even your healthcare providers. However, many of us prefer to talk to our healthcare providers about the expected course of an illness and about our life expectancy when living with a chronic or terminal illness. This is according to new research on advanced care planning (the technical term for having early conversations with our healthcare providers about our care needs, preferences, and expectations).

In a new study published in the Journal of the American Geriatrics Society, examined how older adults with disabilities later in life might react to learning their prognosis, and how they evaluated their own prognosis compared to "official" estimates.

The study participants were 35 adults 70-years-old and older from four geriatrics clinics in the San Francisco Bay area. All the participants required help with daily activities, and they all participated in a 45-minute interview as part of the study.

The researchers asked older adults questions about how they would want to receive information about their . For example, did they prefer hearing or reading news about their prognosis? Would they prefer receiving information about their prognosis while at home by themselves?

Additionally, participants circled the shortest, longest, and most likely number of years they thought they might live on a scale from zero to 30 years. Researchers then offered to give the participants an estimate of life expectancy with a visual presentation using an estimate system created for people older than age 50. Next, participants were given the option to see their prognosis. If they chose to see it, they discussed their reactions with the researchers. Afterward, researchers asked the participants 10 questions about their feelings based on hearing about estimated life expectancy. The researchers called the participants two to four weeks later to check on their reactions as a follow-up.

Over the course of the study, the researchers learned that:

  • 16 participants (46 percent) had life expectancy estimates that were within two years of the "most likely" estimate from a healthcare professional.
  • 15 participants (43 percent) over-estimated their own life expectancy by more than two years compared to the "most likely" estimate.
  • 4 participants (11 percent) under-estimated their own life expectancy by more than two years compared to the "most likely" estimate.
  • Overall, 30 (86 percent) estimated their life expectancy in a way that at least overlapped with the "official" estimated calculation.

The researchers concluded that most older adults wanted a practitioner to be present when discussing life expectancy. People in the study did not react with sadness or anxiety when they learned about life expectancies, though several disputed the calculated results.

"Health care practitioners may offer to discuss life expectancy with their older, disabled patients and expect the patients to tie the information into their own narratives," said the researchers.

According to other research, key reasons for a healthcare professional's reluctance to have these discussions with their may include:

  • Fear of taking away hope
  • Concern for a negative reaction
  • Time restraints
  • Poor training
  • Worry about giving someone a mistaken , leading to incorrect information about a person's future

Addressing these and other important concerns remains key to advance care planning, which has been shown to improve the quality of care we receive as we age.

Explore further: Determining accurate life expectancy of older adults requires provider, patient discussion

More information: Theresa W. Wong et al, Prognosis Communication in Late-Life Disability: A Mixed Methods Study, Journal of the American Geriatrics Society (2017). DOI: 10.1111/jgs.15025

Related Stories

Determining accurate life expectancy of older adults requires provider, patient discussion

October 19, 2015
Health care providers must have detailed discussions with their older adult patients to better determine their true life expectancy, as older adults do not accurately predict their own prognosis, a key factor in making decisions ...

Hospice care is short and may start later than needed

September 12, 2017
Older adults are admitted to hospice for short duration despite experiencing symptoms months prior to the end of life, according to a Yale-led study. The finding highlights the need for earlier hospice admission or other ...

Life expectancy doesn't influence care of keratinocyte carcinoma

June 20, 2016
(HealthDay)—Life expectancy does not appear to influence patterns of treatment for keratinocyte carcinoma (KC), according to a study published online June 15 in the Journal of the American Geriatrics Society.

Apathy is common and may decrease life expectancy in nursing home patients

August 9, 2017
In a study of nursing home patients, apathy was linked with an increased risk of dying over a 4-month period, even after controlling for depression. The study also found that apathy was present in half of nursing home patients.

Extra 71,000 care home places needed in eight years, study warns

August 16, 2017
An extra 71,000 care home places will be needed in England in just eight years to cope with rising numbers of older people unable to live independently, new research has revealed.

Touring senior centers, interacting with residents positively impacts health students

July 31, 2017
A new study has found that a community-based service learning experience involving greater interaction with older adults had a positive impact on career development for medical residents (physicians who have graduated from ...

Recommended for you

Exercise to stay young: 4-5 days a week to slow down your heart's aging

May 21, 2018
Participating in exercise 4-5 days per week is necessary to keep your heart young, according to new research published in The Journal of Physiology. These findings could be an important step to develop exercise strategies ...

Improving heart health could prevent frailty in old age

May 21, 2018
New research has shown that older people with very low heart disease risks also have very little frailty, raising the possibility that frailty could be prevented.

One in 10 parents say their child has gotten sick from spoiled or contaminated food

May 21, 2018
No parent wants to come home from a picnic or restaurant with a little one whose stomachache turns into much worse.

Little difference between gun owners, non-gun owners on key gun policies

May 17, 2018
A new national public opinion survey from the Johns Hopkins Bloomberg School of Public Health finds widespread agreement among gun owners and non-gun owners in their support for policies that restrict or regulate firearms.

Giving employees 'decoy' sanitizer options could improve hand hygiene

May 17, 2018
Introducing a less convenient option for hand sanitizing may actually boost workers' use of hand sanitizer and increase sanitary conditions in the workplace, according to findings in Psychological Science, a journal of the ...

Research shows that sexual activity and emotional closeness are unrelated to the rate of cognitive decline

May 16, 2018
Older people who enjoy a sexually active and emotionally close relationship with their partner tend to perform better at memory tests than sexually inactive older adults on a short-term basis, but this is not the case over ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.