Of all the people that go to a doctor, a significant portion is represented by aged (80’s) women (fewer men survive into their 80’s than women). Selecting or keeping a physician for the elderly is a common experience for family and caregivers and must be done with fact-finding and discernment.

While a patient’s age may impact the logic of a DNR (do not resuscitate) order or a particular treatment protocol, or similar decisions, there is little reason to limit the quality of care, time and attention to clinical competence afforded the elderly compared to that of younger patients in need of medical care. Generally, insurance actuarial records reflect that the elderly are more fragile, less likely to have positive clinical outcomes from hospital stays and recover less rapidly than younger patients of similar morbidity. A higher proportion of senior patients are expected to have complications as compared to younger patients.

You can significantly improve the quality of medical care for your aging parent by being an involved advocate.

• Go to medical appointments with your aging parent.
• With patient consent, ask questions of the physician as to expectations of outcomes relative to therapies and other treatments completed and those proposed. If a treatment is not being considered, ask why it’s not appropriate for your parent.
• Follow up with the doctor regarding the results of diagnostic tests and ask what therapies (if any) may be appropriate.
• Ask guidance from family, friends and other trusted individuals who may have an opinion (based on experience) about a particular physician’s treatment philosophy regarding the elderly.

If you don’t get the detailed answers and dialog from your doctor that you expect or feel is appropriate, make this known to him or her. Evaluate the response you get (if any) based on your experience and instincts.

Some therapies and diagnostic tests are not appropriate in situations where the prognosis and clinical life expectancy dictate limited treatment protocols but the elderly are worthy of the practice of good medicine. Do your part to see that they get it. Be an advocate.