Geriatric Quick Consult

Unrealistic Expectations

Do's / Don'ts

Addressing unrealistic expectations of patients and families

Families usually have a difficult time accepting that their loved one is on the verge of dying, may never walk again, or has to be placed in a home other than their own. Often the elderly are precariously balanced and even a small change in health status can drastically impact their functionality or life expectancy.

Families and patients may be unable to accept the fact that a person with a healed hip fracture, who previously lived independently, is now unable to care for themselves. Most of the time, there is not a simple reason why the person now requires total care. It is usually due to multiple factors.

It is often difficult for families to understand why their very elderly relative who has a number of chronic medical problems and short life expectancy is not a candidate for surgery or chemotherapy for a newly diagnosed cancer.

It is frequently easier not to confront the family about the realities of the situation but it is neither in their best interest nor the interest of the patient.

Keys to addressing unrealistic expectations of patients and families are to remain in close contact with them, listen to their concerns, speak frequently about the situation, and be sure that the entire healthcare team is relating the same message.

DO all of these

DON'T do any of these

First, listen to the patient and family. dictate to the patient or family.
Be honest with the family. leave the patient out of the discussion.
Be sure the entire healthcare team tells the family the same message. ignore the problem.
Have a family meeting. use a family member to be your message carrier.
Ask if speaking with a religious person might help.