Negotiating complexity in spite of scarce evidence—how to care for older ICU patients?
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By
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Michael Beil
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Christian Jung
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Bertrand Guidet
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June 22, 2026
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Clinical Scorecard: Managing Challenges in the Care of Older Patients in the ICU Amid Limited Evidence
At a Glance
| Category | Detail |
|---|
| Condition | Older patients in the ICU |
| Key Mechanisms | Geriatric syndromes and accelerated aging impact critical care decisions. |
| Target Population | Adults aged 65 years and older, with a focus on those aged 80 years and older. |
| Care Setting | Intensive Care Units (ICUs) |
Key Highlights
- Limited evidence and guidance for managing older ICU patients.
- Conditional recommendation for geriatric models of care.
- No strong recommendations for specific interventions due to low certainty of evidence.
- SCCM and ESICM emphasize the need for tailored healthcare for older adults.
- Further research is required to improve outcomes for older ICU patients.
Guideline-Based Recommendations
Diagnosis
Management
- Support the use of geriatric models of care for older adults in the ICU.
- Do not use antipsychotic medications to prevent delirium in older ICU patients.
Monitoring & Follow-up
Risks
- Uncertainty regarding the use of antipsychotic medication to treat delirium.
Patient & Prescribing Data
Older adults aged 65 years and older, particularly those aged 80 years and older.
Evidence for specific interventions remains uncertain; geriatric care models may be beneficial.
Clinical Best Practices
- Integrate additional expertise to manage the complexity of older patients.
- Consider biological aging and its consequences in clinical practice.
Related Resources & Content
