Division of Geriatrics and Palliative Medicine, Weill Medical College of Cornell University, New York.
Department of Health and Nutritional Sciences, Brooklyn College, City University of New York, Brooklyn, New York, USA.
Curr Opin Support Palliat Care. 2019 Mar;13(1):64-68. doi: 10.1097/SPC.0000000000000408.
Cancer has a high incidence and death rate among older adults. The objective of this article is to summarize current literature about communication between older adults and medical professionals in cancer care. Our article addresses four categories related to communication: first, ageism; second, screening; third, treatment; and fourth, end of life (EoL) care.
Current literature suggests that cancer treatment for older patients may be influenced by ageist biases. Older patients prefer that clinicians incorporate health status to individualize screening decisions although some patients don't consider life expectancy to be an important factor in screening. Patients often agree with the oncologists' treatment recommendations but want to be involved in the decision-making process. Lastly, work is being conducted to associate quality communication of EoL issues with hospital performance measures.
Patients are at risk of age-based disparities in cancer screening, treatment, and EoL care. Older adults are not a homogenous group and all elderly cancer patients need to have an individualized approach to care. Medical professionals must understand patients' goals and values and involve them in shared decision-making and preparation for EoL.
癌症在老年人中的发病率和死亡率都很高。本文旨在总结有关癌症护理中老年患者与医疗专业人员之间沟通的现有文献。我们的文章涉及沟通的四个方面：第一，年龄歧视；第二，筛查；第三，治疗；第四，临终关怀。
现有文献表明，老年患者的癌症治疗可能受到年龄歧视偏见的影响。老年患者希望临床医生将健康状况纳入个性化筛查决策，但有些患者不认为预期寿命是筛查的一个重要因素。患者通常同意肿瘤医生的治疗建议，但希望参与决策过程。最后，正在开展工作将临终问题的高质量沟通与医院绩效指标联系起来。
患者在癌症筛查、治疗和临终关怀方面存在基于年龄的差异风险。老年人不是一个同质群体，所有老年癌症患者都需要有个性化的护理方法。医疗专业人员必须了解患者的目标和价值观，并让他们参与共同决策和临终准备。
