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Older people's reasoning for resuscitation preferences and their role in the decision-making process.
Resuscitation. 2005 May; 65(2):165-71.R

Abstract

OBJECTIVES

To investigate older patients' reasoning for their cardiopulmonary resuscitation (CPR) preferences and the related decision-making process (DMP).

METHODS AND SUBJECTS

In a descriptive study 220 elderly home-dwelling cardiovascular patients were interviewed and asked to justify their CPR preferences according to the given statements. Questions related to DMP were asked and their physical function, cognition, mood, and quality of life were assessed.

RESULTS

Resuscitation preferences were associated with several patient characteristics, such as age, mood and quality of life. Patients preferring CPR (114/220, 52%) estimated their prognosis of CPR to be better than those preferring to forgo CPR. They justified their view: "Life is precious and worth living for me" (92%), "Maintaining life is a value of its own" (92%), "I feel needed by my family and my closest" (81%). Participants preferring to forgo CPR (106/220, 48%) justified: "I have already gained old age and led a full life" (88%), "People cannot decide these things" (72%). Only 9% of patients had discussed, and 38% would like to discuss preferences for life-sustaining treatments (LSTs) with their physician. However, 80% of respondents felt that the patients should take some part in the DMP; either alone (9%), together with a physician (23%), or together with a physician and a close relative (48%).

CONCLUSIONS

Older people justify their resuscitation preferences highlighting their experiences of meaningful life or fulfillment of their life, interpersonal relationships with their loved ones and presumed outcome of CPR. Less than a half of the patients wished to discuss CPR and LSTs preferences in their current situation with their physician, but nevertheless wanted to participate in the DMP of end-of-life treatment. Physicians should assess patients' own preferences in-depth.

Authors+Show Affiliations

Helsinki City Hospital Koskela, P.O. Box 6410, FIN-00099 Helsinki, Finland. marja-liisa.laakkonen@kolumbus.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15866396

Citation

Laakkonen, Marja-Liisa, et al. "Older People's Reasoning for Resuscitation Preferences and Their Role in the Decision-making Process." Resuscitation, vol. 65, no. 2, 2005, pp. 165-71.
Laakkonen ML, Pitkala KH, Strandberg TE, et al. Older people's reasoning for resuscitation preferences and their role in the decision-making process. Resuscitation. 2005;65(2):165-71.
Laakkonen, M. L., Pitkala, K. H., Strandberg, T. E., Berglind, S., & Tilvis, R. S. (2005). Older people's reasoning for resuscitation preferences and their role in the decision-making process. Resuscitation, 65(2), 165-71.
Laakkonen ML, et al. Older People's Reasoning for Resuscitation Preferences and Their Role in the Decision-making Process. Resuscitation. 2005;65(2):165-71. PubMed PMID: 15866396.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Older people's reasoning for resuscitation preferences and their role in the decision-making process. AU - Laakkonen,Marja-Liisa, AU - Pitkala,Kaisu H, AU - Strandberg,Timo E, AU - Berglind,Saila, AU - Tilvis,Reijo S, Y1 - 2005/01/26/ PY - 2004/05/14/received PY - 2004/09/29/revised PY - 2004/11/13/accepted PY - 2005/5/4/pubmed PY - 2005/9/2/medline PY - 2005/5/4/entrez SP - 165 EP - 71 JF - Resuscitation JO - Resuscitation VL - 65 IS - 2 N2 - OBJECTIVES: To investigate older patients' reasoning for their cardiopulmonary resuscitation (CPR) preferences and the related decision-making process (DMP). METHODS AND SUBJECTS: In a descriptive study 220 elderly home-dwelling cardiovascular patients were interviewed and asked to justify their CPR preferences according to the given statements. Questions related to DMP were asked and their physical function, cognition, mood, and quality of life were assessed. RESULTS: Resuscitation preferences were associated with several patient characteristics, such as age, mood and quality of life. Patients preferring CPR (114/220, 52%) estimated their prognosis of CPR to be better than those preferring to forgo CPR. They justified their view: "Life is precious and worth living for me" (92%), "Maintaining life is a value of its own" (92%), "I feel needed by my family and my closest" (81%). Participants preferring to forgo CPR (106/220, 48%) justified: "I have already gained old age and led a full life" (88%), "People cannot decide these things" (72%). Only 9% of patients had discussed, and 38% would like to discuss preferences for life-sustaining treatments (LSTs) with their physician. However, 80% of respondents felt that the patients should take some part in the DMP; either alone (9%), together with a physician (23%), or together with a physician and a close relative (48%). CONCLUSIONS: Older people justify their resuscitation preferences highlighting their experiences of meaningful life or fulfillment of their life, interpersonal relationships with their loved ones and presumed outcome of CPR. Less than a half of the patients wished to discuss CPR and LSTs preferences in their current situation with their physician, but nevertheless wanted to participate in the DMP of end-of-life treatment. Physicians should assess patients' own preferences in-depth. SN - 0300-9572 UR - https://www.unboundmedicine.com/medline/citation/15866396/Older_people's_reasoning_for_resuscitation_preferences_and_their_role_in_the_decision_making_process_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0300-9572(04)00473-3 DB - PRIME DP - Unbound Medicine ER -