Tackling Decision-Making Among Older Adults

The New York Times recently reported on a familiar phenomenon: A decreased ability to make snap decisions as we age. If you’re providing care for elderly parents, you’ve likely experienced frustration if you’ve been short on time and had to wait for mom or dad to decide on what they want for lunch, what they’d like to wear or what they’d like to do that day. A few minutes can seem like an eternity for busy members of the sandwich generation, who are often tending to the needs of aging parents in between running children to soccer practice or playdates. Older adults take a different approach to decision-making

It turns out there’s a scientific basis for our diminished decision-making capability as we age. Gregory Samanez-Larkin, a postdoctoral fellow at Vanderbilt University and co-director of the Scientific Research Network on Decision Neuroscience and Aging, studied decision-making for his doctoral dissertation research at Stanford University. Dr. Samanez-Larkin asked subjects ranging in age from 20 to 85 to consider a set of investment options as he monitored their brain activity. He says the brain systems involved in this type of activity are at the core of decision-making.

Dr. Samanez-Larkin says that the way we make decisions changes physiologically as we age, as the brain takes a different approach to tasks. In a more recent study, to be published this month, he compared two groups: subjects in their 20s and 30s to subjects 60 and older, to determine what types of information subjects found useful in decision-making. In this study, Samanez-Larkin found that older adults tend to take a different approach to making decisions when presented with a difficult choice. When there’s no clear answer, the aging brain can perceive tough decisions as overwhelming. This leads many to opt-out completely, which can be detrimental in real-world situations.

Consider the millions of seniors faced with choosing a Medicare Part D prescription drug plan. The many options available and complexity of the programs in general left many seniors feeling helpless. In this case, a total opt-out led to penalties and coverage gaps that could have been avoided.

This doesn’t mean caregivers should make decisions for their aging loved ones, however. Providing ample information to gently nudge the person in the right direction is preferable to giving directives, says Samarez-Larkin.

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