Volume 27
Number 3
Jul 2019
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E. de Jonge, S.P. Mooijaart

Although often life-saving, admission to an intensive care unit is not necessarily beneficial for all older patients. These patients do not always prefer life-extending treatment over care focused on preserving functional capacity or relieving pain and discomfort. Physicians are allowed, even obliged, to choose not to provide treatment that is not for the patient’s good, especially if that treatment is harsh and burdensome. In this paper we propose a model to facilitate better provision of appropriate care based on explicit estimations of baseline physical, cognitive and social status and subjective quality of living, the likelihood of long- term survival and fair/good functional performance, individual preferences and the burden of treatment. While absolute criteria on when to withhold intensive care cannot be given, it is important that physicians have a uniform set of explicit criteria to consider in all older patients.

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