10 Medical Treatments Seniors Should Avoid (Or Question)
As consumers and advocates for our older loved ones, it’s crucial to stay informed, ask questions and get second opinions if necessary. America’s pay-per-service model of health insurance encourages providers to prescribe every test, procedure, and intervention that could be plausibly justified. The result is that many seniors are over-tested, over-treated, and over-medicated. Some medical tests and interventions just don’t make sense for seniors.
In collaboration with over 500,000 physicians in medical specialty societies, the Consumer Reports and the Choosing Wisely initiative created resources for consumers and physicians to engage in important conversations about the overuse of medical tests and procedures that provide little benefit and in some cases harm. On February 21, 2013, the Choosing Wisely campaign released an additional 18 tests or procedures to question, highlighting potentially unnecessary— sometimes harmful— care provided in the United States.
Looking at the latest data from their study, we complied the top treatments that may do seniors more harm than good:
1. Feeding Tubes for the People With Advanced Dementia
Evidence indicates hand feeding is preferable to tube feeding, and feeding tubes may cause agitation, requiring them to be medicated, and increasing the probability of bed sores. (American Geriatrics Society)
2. Benzodiazepines as the First Choice Medication for Seniors with Insomnia or Agitation
Benzodiazepines such as Xanax and Valium can cause accidents, increase the fall risk, and lead to dependency when used long-term. (American Geriatrics Society)
3. Using Antipsychotic Medications for Dementia Behavior Problems
Evidence suggests that antipsychotics do little to help behavior problems associated with dementia, but they can do great harm and have been linked to increased risk of stroke and early death. Non-chemical approaches should be exhausted before antipsychotics are tried. (American Geriatrics Society)
4. Using Antibiotics to Treat Urinary Tract Infection When Symptoms aren’t Present
The presence of bacteria in the urinary tract without the presence of symptoms has been found not to be dangerous, and the use of antibiotics in these situations does more harm than good. (American Geriatrics Society)
5. Use of Opioids for Migraine Except as Last Resort
Drugs such as Vicodin, Percocet, codeine, or morphine can actually make headaches worse in the long-term. (American Geriatrics Society)
6. Leaving Active Implantable Defibrillators in Hospice Patients
Hospice patients may still have an implantable defibrillator that’s active. In hospice patients the defibrillator rarely prevents death, but can be painful for dying patients and traumatic for caregivers. Defibrillators should be deactivated when they no longer play a role in the goals of care. (American Academy of Hospice and Palliative Medicine)
7. Use of Topical Gels to Treat Nausea for Hospice Patients
Topical gels that are often used in hospice care have not been shown to be effective. More effective routes of administration should be used. (American Academy of Hospice and Palliative Medicine)
8. Routine Colonoscopies for People over 75 Except in Special Circumstances
Colonoscopies are costly and carry risks including infections. Routine tests may not be warranted for people over 75. (U.S. Preventative Services Task Force)
9. Routine Prostate Screening for Men over 75 Except in Special Circumstances
The results of prostate screenings in older men often results in the commencement of aggressive treatment, but evidence suggests that this kind of treatment is often unnecessary that it would have been better for many seniors if they had never been tested at all. Testing is only warranted in special circumstances, such as when the elderly patient has a history of prostate cancer. (U.S. Preventative Services Task Force)
10. Mammograms for women over 70 Except in Special Circumstances
Aggressive breast cancer treatment has not been shown to extend the life or improve the quality of life of women over 70, so the mammogram test itself is unnecessary in most cases. (U.S. Preventative Services Task Force)
Are there any treatments that you think seniors should avoid?We welcome your comments and experiences below.
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