It’s crucial to ask questions, get second opinions if necessary and stay informed, as advocates for our parents and senior loved ones. The Consumer Reports and the “Choosing Wisely” initiative created resources for caregivers and physicians to engage in important conversations about the overuse of medical procedures that provide little benefit and in some cases harm, to seniors.
Recently, the “Choosing Wisely” campaign released an additional 18 procedures to question, highlighting potentially unnecessary treatments provided to seniors in the United States. Learn more about these tests.
Medical Treatments Seniors Should Avoid (Or Question)
The “Choosing Wisely” campaign compiled a list of the top treatments that may do seniors more harm than good, which includes:
1. Benzodiazepines for seniors with agitation or insomnia.
Benzodiazepines such as Valium and Xanax can cause accidents, increase falls and lead to dependency when used long-term. (American Geriatrics Society)
2. Feeding tubes for dementia.
Evidence indicates hand feeding is preferable to tube feeding and feeding tubes may cause agitation, requiring people with dementia to be medicated and increasing the probability of bed sores. (American Geriatrics Society)
3. Leaving active implantable defibrillators in seniors in hospice.
In hospice, the defibrillator rarely prevents death in seniors but can be painful for dying patients and traumatic for caregivers. Defibrillators should be deactivated when they no longer play a role in the goals of care. (American Academy of Hospice and Palliative Medicine)
4. Mammograms for women over 70.
Aggressive breast cancer treatment has not been shown to extend the life or improve the quality of life of women over 70, so the mammogram test itself is unnecessary in most cases. (U.S. Preventative Services Task Force)
5. Routine colonoscopies for people over 75.
Colonoscopies are costly and carry risks including infections. Routine tests may not be warranted for people over 75. (U.S. Preventative Services Task Force)
6. Routine prostate screening for men over 75.
The results of prostate screenings in older men often results in the commencement of aggressive treatment, but evidence suggests that this kind of treatment is often unnecessary that it would have been better for many seniors if they had never been tested at all. Testing is only warranted in special circumstances, such as when the elderly patient has a history of prostate cancer. (U.S. Preventative Services Task Force)
7. Use of opioids for migraines.
Drugs such as codeine or morphine can actually make headaches worse in the long-term. (American Geriatrics Society)
8. Use of topical gels to treat nausea.
Topical gels that are often used in hospice care have not been shown to be effective. More effective routes of administration should be used. (American Academy of Hospice and Palliative Medicine)
9. Using antibiotics to treat urinary tract infections when symptoms aren’t present.
The presence of bacteria in the urinary tract without the presence of symptoms has been found not to be dangerous, and the use of antibiotics in these situations does more harm than good. (American Geriatrics Society)
10. Using antipsychotic medications for dementia.
Evidence suggests that antipsychotics do little to help behavior problems associated with dementia, but they can do great harm and have been linked to increased risk of stroke and early death. Non-chemical approaches should be exhausted before antipsychotics are tried. (American Geriatrics Society)
Are there any other medical treatments that you think seniors should avoid? We welcome your comments and experiences below.