Studies find frail seniors often get poor, futile care

Two studies published in the New England Journal of Medicine find that some medical care, especially at the end of life, may be a poor choice for feeble seniors. They also show the importance of palliative care over aggressive treatment for certain patients. The Associated Press reports: "A surprising number of frail, elderly Americans in nursing homes are suffering from futile care at the end of their lives, two new federally funded studies reveal. One found that putting nursing home residents with failing kidneys on dialysis didn't improve their quality of life and may even push them into further decline. The other showed many with advanced dementia will die within six months and perhaps should have hospice care instead of aggressive treatment."

"In one study, doctors looked at health records of 3,702 nursing home residents nationwide who started dialysis between 1998 and 2000. ... Within the first year, 58 percent died and another 29 percent declined in their ability to do simple tasks such as walking, bathing and getting dressed. ... The findings call into question the common practice of transporting dialysis patients near the end of life to dialysis centers several times a week and hooking them up to a machine for hours at a time. The second study followed 323 people with advanced dementia from Boston-area nursing homes. Their average age was 85 and they could not recognize loved ones and were unable to talk or walk. One out of four died within six months and half died during the 18 months they were followed" (Chang, 10/14).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.