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Many Hospitalized Older Patients Need Help With Medical Decisions: Study

Wed, 01/22/2014 - 10:17am

When the time comes for making critical medical decisions while in the hospital, a new study says older people often rely on family members or other surrogates to make those calls.

Researchers found that about half of the older patients they tracked needed help making decisions within two days of being admitted to the hospital.

Considering the aging U.S. population and the mental burden borne by the family and friends making those decisions, the study's lead author told Reuters Health that hospitals should work to accommodate surrogate decision makers.

"The long-term goal would be to improve hospital processes," Dr. Alexia Torke, a center scientist at the Indiana University Center for Aging Research in Indianapolis, told Reuters Health.

Previous studies have examined the role of surrogate decision makers in some medical settings, but Torke and her colleagues write in JAMA Internal Medicine that they couldn't find research showing how often people rely on others to make decisions while in the hospital.

"We set out to describe the scope of the problem as a whole," Torke said.

For the study, she and her fellow researchers analyzed data on people who were over 65 years old and admitted to either of two hospitals in one Midwestern city between November 2008 and December 2011.

To be included in the study, a person had to have been hospitalized for 48 hours. After that time, a doctor was interviewed about the decision making process for that patient. Other information was taken from the patient's medical record.

Of 1,598 study participants, the researchers found that 1,083 faced at least one major medical decision that was discussed with the patient or a surrogate.

Of those cases, about 570 patients made all of their decisions alone, 264 made their decisions with the help of a surrogate and surrogates made all of the decisions for 249 patients.

Most patients with surrogates were in the hospitals' general wards, not the intensive care units.

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