Goals of care
Ask what matters: home, independence, symptom control, hospital avoidance, procedures, resuscitation, family support, and decision-making authority.
Otherwise healthy around 90
Health checks at 90.
At 90, health care should be honest and kind: comfort, independence, medication safety, falls prevention, cognition, hearing, vision, nutrition, pain, and what the person wants.
Main idea
Do the checks that can change care. Do not collect tests for the sake of collecting tests.
Routine screening is often less useful at 90 unless a result would clearly change care in a way the person wants. Symptom diagnosis, comfort, safety, and support are usually the center.
This is not doing less. It is doing what matters: treating pain, breathlessness, depression, infection, anemia, heart failure, fractures, constipation, dental pain, hearing loss, and caregiver stress.
For details on fasting, cost, risks, normal ranges, false abnormal results, and next steps, use 50tests.com.
Suggested focus
A practical checklist for this decade.
These are prompts for a clinician conversation, not a command to get every test.
Medication safety
Stop medicines that no longer help, simplify schedules, avoid falls/confusion, and check kidney function when medicines require it.
Function and comfort
Pain, breathlessness, falls, continence, constipation, nutrition, swallowing, skin, sleep, mood, cognition, vision, and hearing.
Symptom-led testing
Blood tests, urine tests, X-rays, scans, or referrals should answer a clear question and lead to care the person would choose.
Examples
Otherwise healthy example lists.
These change with family history, symptoms, and local guidelines.
Typical male checklist around 90
- Goals-of-care review
- Medication safety
- Symptom-led blood/urine tests
- Falls, cognition, pain, hearing, vision, nutrition
Typical female checklist around 90
- Goals-of-care review
- Medication safety
- Symptom-led blood/urine tests
- Falls, cognition, pain, hearing, vision, nutrition