Abstract
Patients admitted acutely to a geriatric medical unit were interviewed on admission about their opinions on cardiopulmonary resuscitation (CPR). They underwent a general examination and their mental health was documented by completing the geriatric depression scale. Those who did not wish CPR in the event of a cardiac arrest were questioned again on recovery. Of 216 patients admitted, only three objected to answering the questions and after the other exclusion criteria were applied, 100 patients were included in the study. A total of 92% of patients wished CPR in the event of a cardiac arrest. The 8% who did not wish CPR contained more people scoring high on the geriatric depression scale. After recovery, three of that eight had changed their minds and wished CPR if required. Patients who are acutely unwell may make decisions that are influenced by their condition at this point in time and it is important to recognize that these decisions may not be maintained. In this study, consultant geriatricians did not reflect their patients' desires in making decisions about who should receive CPR if required.
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- Emanuel L. The health care directive: learning how to draft advance care documents. J Am Geriatr Soc. 1991 Dec;39(12):1221–1228. [PubMed] [Google Scholar]
- Fried T. R., Gillick M. R. Medical decision-making in the last six months of life: choices about limitation of care. J Am Geriatr Soc. 1994 Mar;42(3):303–307. doi: 10.1111/j.1532-5415.1994.tb01756.x. [DOI] [PubMed] [Google Scholar]
- Gulati R. S., Bhan G. L., Horan M. A. Cardiopulmonary resuscitation of old people. Lancet. 1983 Jul 30;2(8344):267–269. doi: 10.1016/s0140-6736(83)90244-1. [DOI] [PubMed] [Google Scholar]
- Gunasekera N. P., Tiller D. J., Clements L. T., Bhattacharya B. K. Elderly patients' views on cardiopulmonary resuscitation. Age Ageing. 1986 Nov;15(6):364–368. doi: 10.1093/ageing/15.6.364. [DOI] [PubMed] [Google Scholar]
- Liddle J., Gilleard C., Neil A. Elderly patients' and their relatives' views on CPR. Lancet. 1993 Oct 23;342(8878):1055–1055. doi: 10.1016/0140-6736(93)92912-d. [DOI] [PubMed] [Google Scholar]
- Murphy D. J., Burrows D., Santilli S., Kemp A. W., Tenner S., Kreling B., Teno J. The influence of the probability of survival on patients' preferences regarding cardiopulmonary resuscitation. N Engl J Med. 1994 Feb 24;330(8):545–549. doi: 10.1056/NEJM199402243300807. [DOI] [PubMed] [Google Scholar]
- Seckler A. B., Meier D. E., Mulvihill M., Paris B. E. Substituted judgment: how accurate are proxy predictions? Ann Intern Med. 1991 Jul 15;115(2):92–98. doi: 10.7326/0003-4819-115-2-92. [DOI] [PubMed] [Google Scholar]
- Wagner A. Cardiopulmonary resuscitation in the aged. A prospective survey. N Engl J Med. 1984 Apr 26;310(17):1129–1130. doi: 10.1056/NEJM198404263101732. [DOI] [PubMed] [Google Scholar]