One third of elderly Americans undergo surgery during the last 12 months of their lives, most of them within the last month. Yet three quarters of seriously ill patients say they would not choose life-sustaining treatment if they knew the outcome would be survival with severe cognitive or functional impairment. How many of these patients and their caregivers are offered less invasive options? How should such patients be counseled about the risks of complications and functional impairment after major surgery? And who should help them weigh the risks against the potential benefits of surgery?
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