For Medical Professionals
For many older patients, high-risk surgery can prolong their lives and/or improve their symptoms. However, for others, especially those with multiple chronic conditions, the decision to proceed with surgery can launch a care trajectory that leads to potentially unwanted outcomes. These include lower quality of life 1, more hospitalizations 2 , 3, potential suffering at the end of life 4 , 5, prolonged life support 6 or long-term care in a nursing home. Patients and their families may be blindsided by these downstream outcomes.
To mitigate this problem, we need to help older patients fully understand treatment options in the context of their values and preferences before they decide if high-risk surgery is right for them. Our preliminary research has shed light on how patient-surgeon communication patterns may make the decision-making process less effective. For example, we have found that surgeons often use oversimplified language to explain the technical aspects of surgery 7, and focus on specific risk disclosure as required by informed consent guidelines 8.
In our current studies, we are evaluating tools and processes to help close the gap between what surgeons know and patients understand. Those tools empower patients to ask questions about the broader implications of surgery, so they can provide not just informed consent, but communicate informed preferences.