Crystal Ball 2.0: In the five weeks since a team of California doctors launched ePrognosis, the life expectancy-predicting website has attracted more than half a million visits. The site contains 16 questionnaires-or "prognosis calculators"-that can estimate an older patient's survival odds for the next six months up to five years. Intended as a tool for geriatric doctors and other health professionals, many older patients are using the website themselves, says Alexander Smith, a geriatrics professor at the University of California. And to Smith, that's a good thing.
We hope this will stimulate a national dialogue," he said.
Prognosticating about life expectancy was once a typical part of what doctors did. But with today's marvels of modern health care and technology, the focus has shifted to diagnosis and extending lives. Doctors and patients now are much less likely to discuss death and end-of-life planning-which can be awkward, depressing and difficult-as they are treatment options.
Yet a growing number of health care professionals and ethicists say the cost and benefits of screenings, surgery and end of life care for older patients need to be discussed more openly. Sometimes the cost or short-term risks associated with screenings, surgeries or medications exceed any potential benefit for patients with little time left.
The ePrognosis creators hope tools like the site's calculators will help doctors and patients decide what kinds of tests and treatment are prudent or necessary. And it's not all about cutting back-for older patients thought to have many healthy years ahead, this could mean care not generally recommended for people their age.
David Reuben, chief of geriatrics at UCLA's medical school, says he just saw a patient like that. "She was 86 years old, and I told her that in her state of health, we need to be thinking about the next 15 years. She has a good chance of living over 100." Reuben ordered a mammogram - a test not routinely recommended for women that age, who are very unlikely to die of breast cancer before they die of something else.
Tuesday Quick Hits:
- For aging boomers, the workforce is fundamentally different than it was for their parents' generation-and so are retirement prospects.
- Neuroscientists explore how your brain deals with financial risk or loss.
- Three insurance agents have been charged in a $100 million fraud scheme that involved taking out life insurance policies for straw buyers, when the true owners of the policies were third-party investors.
- And America needs to look for new roles for older citizens, says Stanford professor Laura Carstensen. "The shame is that we're only looking at the problems" of any aging population, she said. "There are problems, but we're not looking for opportunities."