Appropriate care for the elderly in the ICU

J Intern Med. 2022 Apr;291(4):458-468. doi: 10.1111/joim.13371. Epub 2021 Oct 5.

Abstract

Life expectancy is rising worldwide and increasing numbers of elderly patients are being admitted to the intensive care unit (ICU). Because ageing is associated with changes in organ function, increased frailty, reduced activities of daily living, reduced mobility, and reduced cognition, elderly patients represent a particular subgroup of ICU patients. Ethical decisions related to the appropriateness of intensive care and/or life-sustaining interventions, the withdrawing and withholding of life support, and terminal sedation are more frequent in these patients and will be discussed in this review. Such decisions must be tailored to the individual to take into consideration personal beliefs and wishes.

Keywords: ICU admission; ageing; autonomy; distributive justice; end-of-life; frailty; proportional care; terminal sedation; withdrawing; withholding.

Publication types

  • Review

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aging
  • Critical Care
  • Hospitalization
  • Humans
  • Intensive Care Units*