REVIEW   

Panminerva Medica 2024 Mar 27

DOI: 10.23736/S0031-0808.24.05089-4

Copyright © 2024 EDIZIONI MINERVA MEDICA

language: English

Ethical issues surrounding appropriate care for older persons in the Intensive Care Unit

Jean-Louis VINCENT ✉

Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium

Increasing numbers of older patients are being admitted to the Intensive Care Unit (ICU) as the world’s population ages. The biological process of ageing, senescence, results in altered ability to maintain normal homeostasis and organ function, including of the cardiovascular, immune, and neuromuscular systems. This contributes towards increased frailty in older patients, associated with functional limitations and increased vulnerability. Although widely defined using chronological age, the concept of “old age” is thus multifactorial, including biological, but also psychological and sociocultural aspects, which should all be taken into account when considering what is appropriate in terms of ICU admission and management. As for all patients, but perhaps particularly in this subgroup, decisions regarding ICU admission and treatment and the withdrawing and withholding of life support must be individualized.

KEY WORDS: Aged; Withholding treatment; Intensive Care Units; Frailty; Aging