Assessing the stability of values and health care preferences of older adults: A long-term comparison.

The purpose of this study was to examine the stability of health care decisions and the influencing values of competent older adults in late life (N = 21) during a 7-year period. Participants were given a list of value indicators from which they were asked to identify the five that most influenced their health care decision-making process. They also were instructed to make decisions related to five health care treatment scenarios and five life-sustaining treatment scenarios across two health states and three different levels of prognosis. Face-to-face interviews were conducted initially followed by telephone interviews 7 years later. No significant change in health care decisions was found for life-sustaining treatments during the 7-year period in study participants. The only significant change between the initial and telephone interviews for health care treatments was an increase in the number of participants not consenting to hip replacement surgery regardless of health state or prognosis. Similarly, change occurred between the initial and telephone interviews with more participants refusing cataract surgery when the prognosis was a 50% chance of recovery. Stability also was noted in the values selected by participants. Four of the top five values selected at the initial interview also were selected 7 years later.