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Patients who want their family and physician to make resuscitation decisions for them: observations from SUPPORT and HELP. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Hospitalized Elderly Longitudinal Project.
J Am Geriatr Soc 2000; 48(S1):S84-90JA

Abstract

OBJECTIVE

To determine the extent to which older or seriously ill inpatients would prefer to have their family and physician make resuscitation decisions for them rather than having their own stated preferences followed if they were unable to decide themselves.

DESIGN

Analysis of existing data from the Hospitalized Elderly Longitudinal Project (HELP) and the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT).

SETTING

Five teaching hospitals in the United States.

PARTICIPANTS

2203 seriously ill adult inpatients (SUPPORT) and 1226 older inpatients (HELP) who expressed preferences about resuscitation and about advance decision-making.

MEASURES

We used a logistic regression model to determine which factors predicted preferences for family and physician decision-making.

RESULTS

Of the 513 HELP patients in this analysis, 363 (70.8%) would prefer to have their family and physician make resuscitation decisions for them whereas 29.2% would prefer to have their own stated preferences followed if they were to lose decision-making capacity. Of the 646 SUPPORT patients, 504 (78.0%) would prefer to have their family and physician decide and 22.0% would prefer to have their advance preferences followed. Independent predictors of preference for family and physician decision-making included not wanting to be resuscitated and having a surrogate decision-maker.

CONCLUSIONS

Most inpatients who are older or have serious illnesses would not want their stated resuscitation preferences followed if they were to lose decision-making capacity. Most patients in both groups would prefer that their family and physician make resuscitation decisions for them. These results underscore the need to understand resuscitation preferences within a broader context of patient values.

Authors+Show Affiliations

Center to Improve Care of the Dying, George Washington University, Washington DC 20037, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

10809461

Citation

Puchalski, C M., et al. "Patients Who Want Their Family and Physician to Make Resuscitation Decisions for Them: Observations From SUPPORT and HELP. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Hospitalized Elderly Longitudinal Project." Journal of the American Geriatrics Society, vol. 48, no. S1, 2000, pp. S84-90.
Puchalski CM, Zhong Z, Jacobs MM, et al. Patients who want their family and physician to make resuscitation decisions for them: observations from SUPPORT and HELP. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Hospitalized Elderly Longitudinal Project. J Am Geriatr Soc. 2000;48(S1):S84-90.
Puchalski, C. M., Zhong, Z., Jacobs, M. M., Fox, E., Lynn, J., Harrold, J., ... Teno, J. M. (2000). Patients who want their family and physician to make resuscitation decisions for them: observations from SUPPORT and HELP. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Hospitalized Elderly Longitudinal Project. Journal of the American Geriatrics Society, 48(S1), pp. S84-90.
Puchalski CM, et al. Patients Who Want Their Family and Physician to Make Resuscitation Decisions for Them: Observations From SUPPORT and HELP. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Hospitalized Elderly Longitudinal Project. J Am Geriatr Soc. 2000;48(S1):S84-90. PubMed PMID: 10809461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patients who want their family and physician to make resuscitation decisions for them: observations from SUPPORT and HELP. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Hospitalized Elderly Longitudinal Project. AU - Puchalski,C M, AU - Zhong,Z, AU - Jacobs,M M, AU - Fox,E, AU - Lynn,J, AU - Harrold,J, AU - Galanos,A, AU - Phillips,R S, AU - Califf,R, AU - Teno,J M, PY - 2000/5/16/pubmed PY - 2000/6/8/medline PY - 2000/5/16/entrez KW - Death and Euthanasia KW - Empirical Approach KW - Hospitalized Elderly Longitudinal Project (HELP) KW - Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) SP - S84 EP - 90 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 48 IS - S1 N2 - OBJECTIVE: To determine the extent to which older or seriously ill inpatients would prefer to have their family and physician make resuscitation decisions for them rather than having their own stated preferences followed if they were unable to decide themselves. DESIGN: Analysis of existing data from the Hospitalized Elderly Longitudinal Project (HELP) and the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT). SETTING: Five teaching hospitals in the United States. PARTICIPANTS: 2203 seriously ill adult inpatients (SUPPORT) and 1226 older inpatients (HELP) who expressed preferences about resuscitation and about advance decision-making. MEASURES: We used a logistic regression model to determine which factors predicted preferences for family and physician decision-making. RESULTS: Of the 513 HELP patients in this analysis, 363 (70.8%) would prefer to have their family and physician make resuscitation decisions for them whereas 29.2% would prefer to have their own stated preferences followed if they were to lose decision-making capacity. Of the 646 SUPPORT patients, 504 (78.0%) would prefer to have their family and physician decide and 22.0% would prefer to have their advance preferences followed. Independent predictors of preference for family and physician decision-making included not wanting to be resuscitated and having a surrogate decision-maker. CONCLUSIONS: Most inpatients who are older or have serious illnesses would not want their stated resuscitation preferences followed if they were to lose decision-making capacity. Most patients in both groups would prefer that their family and physician make resuscitation decisions for them. These results underscore the need to understand resuscitation preferences within a broader context of patient values. SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/10809461/Patients_who_want_their_family_and_physician_to_make_resuscitation_decisions_for_them:_observations_from_SUPPORT_and_HELP__Study_to_Understand_Prognoses_and_Preferences_for_Outcomes_and_Risks_of_Treatment__Hospitalized_Elderly_Longitudinal_Project_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0002-8614&date=2000&volume=48&issue=S1&spage=S84 DB - PRIME DP - Unbound Medicine ER -