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Communicating to older patients that routine screening tests are no longer recommended can prove difficult. Recent research, however, offers guidance on how nurses and other clinicians should approach such conversations.
As we report in a September news article, a study focused on cancer screening found that older adults unlikely to benefit from certain tests were receptive to recommendations to stop screening, with a caveat: they preferred that life expectancy not be a part of the conversation.
The study’s accompanying editorial notes that broaching the topic of life expectancy can turn a discussion about maintaining health into an unexpected discussion about the end of life, which “may be a shock in the primary care setting at a routine visit.” The authors of the study recommend changing the language used in these conversations—for example, saying “This test would not help you live longer” instead of referring to “life expectancy.”
How is this study relevant for nurses? AJN‘s news article quotes Katherine Abraham Evans, president of the Gerontological Advanced Practice Nurses Association, who says:
“It is critical that nurses understand when testing is no longer indicated and know how to communicate this to patients.”
She recommends that nurses “explore their comfort in engaging in critical conversations, and, if necessary, seek training before discussing treatment preferences.”
See more news stories from our September issue, which are free to access:
A couple of years ago, i went to my physician for an annual check. She told me i didn’t need any more routine checks. It just felt like “and then you die”! We won’t do anything more for you. While i was over 75 at the time, i am healthy, keep active, and expect to live quite awhile. It was quite a jolt to hear that i wasn’t “worth” monitoring any more!