The effect of hospital admission on the opinions and knowledge of elderly patients regarding cardiopulmonary resuscitation

• Published in: Age and ageing 1997-11, Vol.26 (6), p.29
• Main Authors: Watson, Daniel R, Wilkinson, Tim J, Sainsbury, Richard, Kidd, Julie E
• Format: Article
• Language: English
• Subjects: Aged patients; Beliefs, opinions and attitudes; Cardiopulmonary resuscitation; CPR (First aid); Elderly patients
• ISSN: 0002-0729; 1468-2834

Objective: to determine (i) if the opinions of elderly people, regarding their wish for cardiopulmonary resuscitation (CPR), change after staying in hospital, (ii) how much elderly people wish to be involved in making decisions about CPR and (iii) the degree of knowledge they use to make their decisions. Design: consecutive sample survey. Setting: assessment, treatment and rehabilitation unit. Patients: 95 elderly inpatients (63% of all admissions) without a terminal illness who could give informed consent, interviewed after hospital admission. Sixty-seven were interviewed again at hospital discharge and three were interviewed 16-35 days after admission. Intervention: patient education and semi-structured questionnaire. Outcome measures: patients' knowledge and opinions on basic knowledge of CPR, preference for CPR, who should decide and how this should be documented. Results: knowledge improved after intervention, although patients persistently overestimated the success rate of CPR. Eighty percent on admission and 69% following a hospital stay wished to have CPR if necessary. Men were more likely to want CPR. On admission, 74% stated the patient should make the decision regarding CPR. This rose to 84% after a hospital stay. Only 57% wished to have their preference recorded in the hospital record and only 43% wanted their general practitioner notified of their wishes. Ninety-four percent felt comfortable with the interview. Conclusions: elderly people wish to be consulted about CPR but many do not wish their preference to be committed to paper. Most older patients want CPR but these wishes may change with time. It is important that any recorded directive from a patient is updated frequently. Keywords: cardiopulmonary resuscitation, elderly patients, patient understanding;