Hospitalized seniors likely to need family help, study finds

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Surrogates often make decisions for seniors, Alexia Torke says.
Surrogates often make decisions for seniors, Alexia Torke says.

Nearly half of hospitalized seniors facing a major treatment decision require help from family members, a new study finds.

These decisions include whether the senior should go to a skilled nursing facility after discharge, as well as whether the patient should be on a ventilator or whether to have a medical procedure, according to Alexia Torke, M.D., a Regenstrief Institute investigator and associate professor of medicine at Indiana University School of Medicine.

Physicians often have to ask children or spouses about decisions due to delirium, dementia or other types of cognitive impairment in the patient, the researchers found. 

“The current hospital structures and routines of daily bedside rounds are built on the assumption that the patient can provide historical information and make decisions independently,” the authors wrote. “Clinicians also frequently report making decisions with surrogates to be highly stressful.”

Investigators looked at more than 1,000 hospitalized patients facing a major decision and did follow-up on the nearly 600 patients who needed surrogate involvement. Of those, 34% were on Medicaid, and 11% had been admitted from a nursing home. They tended to be more seriously ill and were more likely to go to a nursing home or rehabilitation facility after discharge. 

Results were published in JAMA Internal Medicine.


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