A recent article titled The Talk Seniors Need To Have With Doctors Before Surgery raised several interesting issues about the doctor-patient relationship and how we make treatment decisions. While the idea of taking control of your health care often refers to literal life and death decisions or having others step in when you are incapacitated, it is much broader than that. It’s about quality of life. According to the article, older patients often have different priorities than younger ones in treatment, valuing their ability to live independently and spend quality time with loved ones over longevity. However, this is not discussed in most health care (or family) settings. That is changing as many health professionals are advocating for these conversations.

This approach is now integrated into new standards for geriatric surgery by the American College of Surgeons. The standards emphasize “shared decision-making,” which involves asking about patient health goals, goals for the procedure, expectations for their recovery and their quality of life after surgery. In addition, it encompasses more detailed review of their advance care directives – what care they want if things do not go as planned.

As an elder law attorney, I advocate for these same discussions to occur with family members and with those designated as a health care proxy. These parties must understand what is important to you – what quality of life means to you. It is not just about when to “pull the plug;” it’s about how you view the risks and rewards of treatment. As long as you are capable, those decisions are in your hands, but it is beneficial to explain them to your loved ones who may think very differently than you. Shared decision making helps your family support you during a health crisis and take over for you and fulfill your wishes if necessary.

No one likes to think about something bad happening to them or a loved one, but medicine is advancing rapidly. Although there are more treatment options available than ever before, we all have to decide for ourselves how far we are willing to go to address a health crisis and discuss those decisions with others so they know what to do when we cannot make those decisions for ourselves.

I advocate for being a PRO CHOICE SENIOR, which means saying YES to –

  • Aging with an informed Attitude
  • Creating an Aging support system
  • Having ‘difficult conversations’ when necessary!

A PRO CHOICE SENIOR creates his/her own aging playbook where they make as many decisions as possible about their future.

For help planning for your future care, contact me for a consultation.

To learn more about this topic, read Being Mortal by Atul Gawande, MD, MPH