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Elderly patients' preferences concerning life-support treatment
M J Heap1, R Munglani, J R Klinck
1Department of Anaesthesia, Norfolk and Norwich Hospital.
Anaesthesia
|December 1, 1993
Summary
Elderly patients prefer artificial ventilation for good outcomes but desire less intervention as recovery chances decrease. Many wish to self-direct or use advance directives for critical care decisions.
Area of Science:
- Geriatric Medicine
- Medical Ethics
- Critical Care
Background:
- Understanding end-of-life care preferences is crucial for elderly patients.
- Advance care planning for critical illnesses like overwhelming illness requires patient input.
Purpose of the Study:
- To investigate the preferences of elderly patients regarding artificial ventilation.
- To explore patient desires for decision-making autonomy in severe illness.
Main Methods:
- A questionnaire was administered to 118 elderly patients (aged 70-97).
- Patient preferences for artificial ventilation were assessed based on anticipated outcomes and quality of life.
Main Results:
- Most patients desired artificial ventilation if a good outcome was probable.
- Approximately 50% of patients' desire for treatment decreased with lower anticipated quality of life or recovery.
- 40% of mentally competent patients wished to decide on ventilation themselves.
- 24% of mentally incompetent patients preferred advance directives.
Conclusions:
- Elderly patients' preferences for life-sustaining treatment are contingent on prognosis and quality of life.
- Patient autonomy in decision-making, through direct choice or advance directives, is significant for end-of-life care in this demographic.