[Decisions and attitudes of nurses in the care of chronically ill elderly patients].

Data of 182 nurses from two teaching hospitals regarding their attitudes to determinants of the decision-making process in elderly patients in general and decisions in the treatment of an moderately demented, incompetent elderly man with a potentially reversible life-threatening illness using a scenario were analyzed. 68.1 percent complied to the patient's will when an advance directive existed. One fifth reported that the patient's directive was supportive for the decision. The more important the wishes of the patients were evaluated, the more frequent a less aggressive treatment choice was preferred and the less frequent the decision was for resuscitation in the case of a cardiac arrest. The increased use of advance directives is desirable to reduce the number of conflicts in decision-making for healthcare professionals and to reduce the patients' fears of over- or undertreatment and for increasing their possibilities of self-determination. A more intensive integration of topics such as death and dying, treatment of the chronically ill elderly as well as possibilities and limitations of patient directives and their use in the education of nurses is required.