How older patients want to discuss health concerns

May 9, 2018, Johns Hopkins University
Credit: CC0 Public Domain

Nancy Schoenborn, M.D., assistant professor in the Department of Geriatric Medicine and Gerontology at the Johns Hopkins University School of Medicine, and colleagues went straight to the source and conducted three qualitative studies that put older adults at the forefront in order to gain a better understanding of if, and how, they prefer to discuss various health topics.

Let's Talk About Life Expectancy … or Not?

In a small group study published in November 2017 in the Journal of the American Board of Family Medicine, researchers interviewed 40 on how and when they preferred to discuss with their primary care doctor. Schoenborn and team found that 32.5 percent of participants never wanted to discuss their life expectancy, 35 percent were open for discussion if expectancy were longer than one year, and 32.5 percent only wanted to have this discussion toward the end of life. Researchers also found that the majority of the participants, even the ones who never wanted to discuss, were open to be offered the opportunity to discuss life expectancy with their primary care doctor. This research also assessed how the discussion should be phrased when initiating the conversation about life expectancy with older adults.

Frailty Misconceptions

Due to the negative perception of the word "frail," older adults oftentimes overlook frailty as a medical syndrome. Researchers at Johns Hopkins Medicine conducted the first study in the United States that explored older adults' perception of frailty. It was published on Feb. 13, 2018, in BMC Geriatrics.

In a study of 29 participants, Schoenborn and team conducted focus groups with participants in various frailty statuses (frail, prefrail, nonfrail) and at different ages to evaluate existing ideas about frailty. Three major themes were established through this research. First, older adults' ideas about frailty were different from the medical definition of frailty. Many of the participants associated old age with frailty, but not everyone who ages develops the medical syndrome of frailty. Second, participants who were in the nonfrail or prefrail stages were strongly against discussing frailty with their physicians. However, frail participants were more open to having the discussion, but without being labeled "frail." Third, participants in all frailty statuses wanted information regarding prevention of frailty or ways to improve their current condition. This study provides insight on how older adults perceive frailty, but further research needs to be conducted to understand the proper way in which physicians should communicate about .

To Stop or Not to Stop Cancer Screening in Older Adults

Screening for in older adults with limited life expectancy can oftentimes be more harmful than beneficial. However, studies have shown that clinicians may feel uncomfortable stopping cancer screenings on patients with limited life expectancy. In a study published on Aug. 1, 2017, in JAMA Internal Medicine, Schoenborn and other Johns Hopkins researchers conducted interviews with 40 older adults who were 65 years or older to understand what this population thought about stopping cancer screening when life expectancy is limited. Researchers found that the participants were open to considering cessation of cancer screenings. In addition, their willingness to consider stopping screenings was dependent on trusting their physicians. The expressed that they would commend their physicians for even providing this option. This study showed that older do not use life expectancy as a factor when deciding to stop screening; they are more likely to use age and health status to make this decision. Even though life expectancy was not used as a factor when deciding, the group was divided on whether or not physicians should discuss life expectancy in the cancer screening conversation. Researchers also found that the way a physician words the message about life expectancy is very important during the discussion about cancer cessation.

Explore further: Pharmacists can play role in identifying frailty

More information: Nancy L. Schoenborn et al. Older adults' perceptions and informational needs regarding frailty, BMC Geriatrics (2018). DOI: 10.1186/s12877-018-0741-3

Nancy L. Schoenborn et al. Older Adults' Preferences for When and How to Discuss Life Expectancy in Primary Care, The Journal of the American Board of Family Medicine (2017). DOI: 10.3122/jabfm.2017.06.170067

Related Stories

Pharmacists can play role in identifying frailty

May 5, 2018
(HealthDay)—As the number of older people in the United States continues to increase, pharmacists and health care professionals need to recognize and address the health care challenges associated with age, including frailty, ...

Structured exercise program provides mobility benefits to all older patients, regardless of frailty status

January 8, 2018
Physicians should prescribe physical activity to all older patients, regardless of frailty status. A structured, moderate-intensity physical activity program was not associated with a reduced risk for frailty over 2 years ...

Questionnaire-based approach valid for identifying frailty

April 11, 2017
(HealthDay)—A questionnaire-based approach seems to be valid for identifying adults in the intensive care unit with a frailty phenotype, according to a study published online March 30 in the Annals of the American Thoracic ...

Mid-life chronic inflammation may be linked to frailty later

April 26, 2018
A study of nearly 6,000 Americans followed for 24 years from middle to late adulthood found that having chronic inflammation in middle age may be linked to an increased risk of frailty and overall poorer health decades later.

Research helps frail older people in hospitals

April 26, 2018
Researchers led by the University of Leicester have devised a 'risk score' which will be used to help frail older people have better support in hospital.

Poor dental health increases risks of frailty in older men

January 4, 2018
Oral health issues are common among older adults. These issues include tooth loss, gum disease, tooth decay, and dry mouth. These conditions can also affect an older adult's well-being because they may make it harder to eat, ...

Recommended for you

Accurate measurements of sodium intake confirm relationship with mortality

June 21, 2018
Eating foods high in salt is known to contribute to high blood pressure, but does that linear relationship extend to increased risk of cardiovascular disease and death? Recent cohort studies have contested that relationship, ...

Fans of yoga therapy have yet to win over doctors

June 21, 2018
Yoga practitioners often tout the unique health benefits of the ancient discipline—from relieving stress and pain to improving vascular health—but most doctors remain sceptical in the absence of hard proof.

Fruit and vegetables linked to changes in skin colour, new research finds

June 21, 2018
Skin colour in young Caucasian men is strongly linked to high levels of fruit and vegetable consumption, new research by Curtin University has found.

What a pain: The iPad neck plagues women more

June 20, 2018
Is your iPad being a literal pain in the neck?

Medicaid work requirements and health savings accounts may impact people's coverage

June 20, 2018
Current experimental approaches in Medicaid programs—including requirements to pay premiums, contribute to health savings accounts, or to work—may lead to unintended consequences for patient coverage and access, such ...

Introduction of alcohol found to adversely impact fertility rates in hunter-gatherer community

June 19, 2018
Fernando Ramirez Rozzi, a research director with the French National Centre for Scientific Research has found that the introduction of alcohol to a Baka pygmy hunter-gatherer society caused fertility rates to fall. In his ...

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.