Resuscitating the elderly: what do the patients want?

OBJECTIVES

To study the resuscitation preferences, choice of decision-maker, views on the seeking of patients' wishes and determinants of these of elderly hospital in-patients.

DESIGN

Questionnaire administered on admission and prior to discharge.

SETTING

Two acute geriatric medicine units (Southampton and Poole).

PARTICIPANTS

Two hundred and fourteen consecutive consenting mentally competent patients admitted to hospital as emergencies.

RESULTS

Resuscitation was wanted by 60%, particularly married and functionally independent patients and those who had not already considered it. Not wanted resuscitation was associated with lack of social contacts. Sixty-seven per cent welcomed enquiry about their preferences and 78% wanted participation in decision, 43% as sole decision-maker. Wishing to choose oneself was associated with not wanting resuscitation, prior knowledge of it, and lack of a spouse. Patients' opinions remained stable during their admission.

CONCLUSIONS

Discussion of resuscitation is practical on hospital admission without causing distress and the views expressed endure through the period of hospitalisation. Elderly patients' attitudes depend partly on personal health and social circumstances. This may assist doctors when patients are unable to participate themselves.