Do all elderly patients really need ICU care? What about those individuals who have endstage emphysema, advanced cancer or severe heart disease?
For such patients palliative care might just be the right option. Palliative care will treat symptoms of the disease without going for a cure. This differs from both hospice, which is end of life care where the goals are more comfort only and from standard care, where the idea is to treat the disease as best as possible.
So for example, if an 80 year who is on oxygen for severe lung disease, comes in with pneumonia, with palliative care he or she would not be admitted to the ICU, but rather cared for on the floor.Antibiotics might be given if needed and respiratory nebulizers or inhalers as well, but a breathing tube would not be placed nor would a central line (or a line placed into a large vein often near the heart).In other words- less invasive procedures with the goal of improving the symptoms but not curing the disease.
ICU care for elderly patients is not only expensive, it is often very invasive, painful and can lead to complications such as hospital acquired pneumonia, resistant infections and blood clots to mention just a few. And, as these patients are near the end of life, such aggressive treatments might not be in their best interest.
What is best for such patients might not be the full on treatment but rather just a little bit here and there.