Treatment of older people

Abstract

Decisions to treat older people rely on accurate assessment of the patient, on clinical needs of the individual, based on risks and benefits of specific treatment and ethical principles, including the right of individuals to accept or refuse treatment. In those who lack capacity to make decisions, the physician tries to ensure that his decision is based on “best interests” principles set out in the Mental Capacity Act 2005. While no physician will admit to age discrimination, in reality there is evidence of inequalities in care and treatment in hospitals, and it is this fact that has led the Government to outlaw discrimination in healthcare under the new provision of the Equality Act 2010. This of course will not mean that all individuals with the same condition will have the right to receive the same treatment—decisions in each case will be based on an individual's clinical need—this fact alone may lead to difficult discussions with relatives and carers, particularly in relation to end-of-life care. This article provides an overview of the basis of management of older patients, and illustrates the importance of taking a holistic approach in the decision-making process.