older people’s health issues
Therapeutic Objectives in Older People
Introduction
Medical interventions (such as medical testing and treatments) almost always carry some risks. Those risks could impact Quality of Life in Older People . Patients and health care practitioners should weigh the benefits of tests and treatments against the potential negative impacts on quality of life (see also Potential benefits of medical interventionsinclude the following: Cure Increased life expectancy Slowing of disease progression Improved quality of life (such as being more able to go about daily activities) Symptom relief Prevention of complications Potential negative effects of medical interventionsinclude the following: Death Symptoms, such as discomfort, prolonged fatigue, loss of muscle strength, reduced mobility, and incontinence Inconvenience Cost Need for additional tests or treatments When treatments are very likely to achieve benefits and very unlikely to have negative effects, decisions are relatively easy. However, when there are potentially significant negative effects, people need to work with their doctors to make the decisions that take into account quality of life. For example, aggressive cancer therapy may prolong life but have severe negative effects (including chronic nausea and vomiting) that greatly reduce quality of life. In this case, the person’s preference for quality of life versus duration of life and tolerance for risk and uncertainty may change or create health care goals and help guide what medical interventions to pursue. The person’s perspective on quality of life may also affect treatment decisions when different treatments (for example, having surgery or taking medicines) may have different benefits, negative effects, or both. Health care practitioners can help people understand what could happen with the various treatment options, enabling people to make more informed decisions regarding Medical Testing Decisions and When making medical decisions, life expectancy often matters more than age. For example, people with a limited life expectancy may not live long enough to benefit from aggressive treatment of a slowly progressive disorder (for example, radical prostatectomy for a localized, slow-growing prostate cancer). Nevertheless, even people with a limited life expectancy may consider having invasive treatments that may improve quality of life (for example, joint replacement surgery). Regardless of the overall treatment goals, doctors consider the need to relieve symptoms, such as pain, nausea, and shortness of breath. Having to live with such symptoms can significantly affect quality of life. 