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Elderly patients' preferences for long-term life support
1Presbyterian-St Luke's Medical Center, Denver, Colo., USA.
Objective:
To study elderly patients' preferences regarding mechanical ventilation and tube feeding and to compare their preferences for short-term use with their preferences for long-term use of these life support interventions.
Design:
Interviews with patients by clinicians during routine office visits.
Setting:
Hospital-based, primary care geriatrics clinic in downtown Denver, Colo.
Patients:
Two hundred eighty-seven elderly persons (mean age, 77 years; range, 60-99 years).
Main Outcome Measures:
Preferences to use or withhold: (1) short-term mechanical ventilation; (2) long-term mechanical ventilation; (3) short-term tube feeding; and (4) long-term tube feeding.
Results:
Of the total sample, 253 patients (88%) would prefer short-term mechanical ventilation if the chance of recovering was reasonably good but only 11 (3.5%) would prefer long-term mechanical ventilation. One hundred eighty-nine (65%) would prefer short-term tube feeding, but only 13 (4.5%) would prefer long-term tube feeding in the setting of significant cognitive impairment.
Conclusions:
Most elderly persons opt for short-term mechanical ventilation or tube feeding if the chance of recovering is reasonably good. Only a small minority would opt for long-term mechanical ventilation or tube feeding.