The over doctoring of the elderly; do all those meds really improve their health?

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  Elderly hospital patient In Florida, many of my parent's friends visit doctors almost weekly looking for answers to problems that are solely age-related. Most doctors medicate what they cannot solve, and some continue to run test after test as if it will make a difference in the outcome, which in the end is the same for all of us. Doctors' offices are filled with people such as these who just want some relief and some good advice, or perhaps a referral to someone who may have a better answer. In nursing homes across the nation, there are many people who suffer from Dementia, yet are still taking statins, heart medications, and other drugs that are never going to improve their deteriorating conditions. They are kept on their daily medication regimens which may ultimately prolong the life of their body, yet, their minds may no longer be functioning. Perhaps this is part of their business model since the longer their body stays alive, the home can earn income. While extending life may appease some, other times orders not to treat are ignored outright and treatments are administered which are not valuable at the end of someone's life. One has to wonder if this would change instantly if nobody had a Medicare or other insurance since there would no longer be a place to mindlessly bill for medically unhelpful services. Would these same patients pay out of pocket for something of dubious benefit? In other cases, a patient near death is continually given doses of a drug or a chemotherapy treatment that will not alter the course of their treatment. The NY Times recently ran an article discussing this ethical dilemma, that I thought you may wish to read since it may concern you, or a loved one in the future.

Near-Death, and Overmedicated


How sick and disabled, how far into advanced dementia, how close to death do elderly nursing home patients have to be before their physicians stop prescribing drugs that can cause uncomfortable side effects but show scant evidence of helping them?

Let me quickly acknowledge that this was my own reaction to a study published on Monday in JAMA Internal Medicine, part of its weekly "Less Is More" series. Researchers use far more measured terms; sometimes the things they report make you wonder how they manage that.

Consider this nationwide sample of 5,406 people with a diagnosis of advanced dementia who spent at least 90 days in a nursing home between 2009 and 2010. Most were over age 85 and had other diseases as well. The great majority, almost 70 percent, had a do-not-resuscitate order.

It's always a heartbreaking situation. Dementia is a terminal disease, although family members don't always recognize that and health care professionals don't always explain it. By definition, these patients can no longer recognize family members; most are bedridden, with a vocabulary that has shrunk to five words or fewer.

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