Herrera-Tejedor Juan
Unidad de Geriatría, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo, España.
Rev Esp Geriatr Gerontol. 2017 Jul-Aug;52(4):209-215. doi: 10.1016/j.regg.2016.08.002. Epub 2016 Oct 15.
The preferences of the very elderly are not taken into account in healthcare planning. For this reason, a medical literature review was performed in order to fill the gap in appropriate information on this issue. The majority of them think that they receive good healthcare. They favour building a trusting relationship, with the physician handling their decision-making. They also maximise their quality of life at the expense of quantity, and give great importance to comfort and safety. Most of them express the wish to be cared for and die at home. But when an acute event occurs, they want to be transferred to hospital. More explicit communication must be encouraged between very elderly patients, providers, and families to meet their subjective needs, through on-going discussions, focused on expected outcomes and patient care goals. A healthcare system designed to look after them should be based on individual and flexible care, with coordination between healthcare services. Such a healthcare system could enable a growing number of them to die in their preferred conditions.
在医疗保健规划中，未考虑到高龄老人的偏好。因此，开展了一项医学文献综述，以填补这一问题相关适当信息的空白。他们中的大多数人认为自己得到了良好的医疗保健。他们倾向于建立信任关系，由医生处理他们的决策。他们还以牺牲生命数量为代价来最大化生活质量，并高度重视舒适和安全。他们中的大多数人表示希望在家中得到照料并离世。但当急性事件发生时，他们希望被送往医院。必须鼓励高龄老人、医疗服务提供者和家庭之间进行更明确的沟通，通过持续讨论，聚焦预期结果和患者护理目标，以满足他们的主观需求。旨在照料他们的医疗保健系统应基于个性化和灵活的护理，并实现医疗服务之间的协调。这样的医疗保健系统可以使越来越多的高龄老人在他们偏好的条件下离世。
