Preferences for CPR among the elderly: the influence of attitudes and values

While many older individuals wish to forgo cardiopulmonary resuscitation regardless of potential positive outcomes, others desire this intervention despite low chances of survival. This study examines the extent to which health, function, attitudes, and values influence preferences for cardiopulmonary resuscitation.

An in-person, physician-administered survey.

Three clinical sites affiliated with a university-based geriatrics program.

One hundred three individuals age 65 or older with ability to speak, read, and write English.

Demographic, health and functional status, social involvement, religiosity, attitudes, and values were assessed. A standard description of cardiopulmonary resuscitation was followed by open-ended questions regarding treatment preferences.

Mean age was 81 (+/- 7), 66% were women and 78% had an advance directive. The majority (75%) declined cardiopulmonary resuscitation. Women were more likely to decline cardiopulmonary resuscitation. Attitudes toward life were the strongest predictors for the cardiopulmonary resuscitation decision. Family issues were important, especially the prospect of becoming a burden, as well as the outcome of cardiopulmonary resuscitation.

Attitudes toward life, perceived outcome of cardiopulmonary resuscitation, and family issues play a significant role in end-of-life treatment decision-making.