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Prognosis Communication in Late-Life Disability: A Mixed Methods Study.
Theresa W Wong1, Sean Lang-Brown2,3, Rafael D Romo3,4
1University of California San Diego, School of Medicine, San Diego, California.
Journal of the American Geriatrics Society
|September 15, 2017
Summary
Discussing long-term prognosis with disabled older adults is safe. Most patients integrate life expectancy into their personal narrative without significant distress, suggesting clinicians can initiate these conversations.
Area of Science:
- Gerontology
- Clinical Medicine
- Health Communication
Background:
- Prognosis communication is crucial for older adults with late-life disability, yet clinicians fear potential harm.
- Understanding patient reactions is vital for informed clinical practice.
Purpose of the Study:
- To investigate the safety and patient reactions to discussing prognosis in older adults with late-life disability.
- To explore how individuals integrate life expectancy information into their personal context.
Main Methods:
- Thirty-five community-dwelling older adults (≥70 years) with functional limitations participated.
- Participants compared self-estimated life expectancy with a calculated prognosis, followed by semi-structured interviews.
- Qualitative data were analyzed using constant comparative analysis; psychological and behavioral outcomes were tracked over 2-4 weeks.
Main Results:
- Approximately half of participants' self-estimated life expectancies aligned with calculated results.
- A dominant theme was 'fitting life expectancy into one's narrative,' encompassing locus of control, perceived health, and outlook.
- Negative emotional responses like anxiety or sadness were infrequent.
Conclusions:
- Discussing prognosis with disabled older adults appears safe, with most patients adapting the information into their life story.
- Clinicians can likely offer prognosis discussions, as adverse psychological reactions are rare.
- This supports integrating open communication about long-term outlook into geriatric care.
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