Unrepresented Older Adults: A Critical Review and Future Agenda in the Context of the Quintuple Aim

AbstractPurpose of ReviewThe purpose of this review is to provide a critical summary and analysis of the literature published over the past five years regarding unrepresented older adults, with emphasis on five essential themes: 1) terminology; 2) demographics and risk factors; 3) approaches to decision making; 4) adverse outcomes; and 5) preventive interventions.FindingsThe term “unrepresented” has become increasingly favored in the medical literature to describe incapacitated older adults who lack an advance directive and surrogate decision maker. Considerable gaps exist in the literature regarding demographics and risk factors, adverse outcomes, and preventive interve ntions. There are substantially different approaches to decision making for unrepresented older adults, which vary by state and institution.SummaryUnrepresented older adults are among the most vulnerable and salient patients in any health care system. Frequently, these patients are hidden in plain sight until a crisis occurs. We evaluated the recent literature on unrepresented older adults, focusing on essential themes that emerged from our review. We frame our discussion in context of the Quintuple Aim for health care suggesting future research aimed at improving population health outcomes, improving patient experience, reducing health care costs, improving care team well-being, and advancing health equity.

Source: Current Geriatrics Reports - February 17, 2024 Category: Geriatrics Source Type: research