End-of-life Preferences in Elderly Patients Admitted for Heart Failure

QJM. 2004 Dec;97(12):803-8. doi: 10.1093/qjmed/hch135.

Abstract

Background: Heart failure is increasing in prevalence and incidence, with considerable mortality among the elderly.

Aim: To determine preferences concerning cardiopulmonary-resuscitation (CPR) and end-of-life care in elderly patients hospitalized for heart failure.

Design: Prospective interview-based survey.

Methods: Patients >64 years old admitted for acute heart failure were interviewed to address their preferences regarding end-of-life care and cardio-pulmonary resuscitation (CPR) when facing the last stages of their disease.

Results: We interviewed 80 patients (mean age 79 years; 58% women). Thirty-two (40%) expressed a wish not to have CPR. Only two had previously discussed their CPR preferences with their physicians. When recovery from the illness was considered unlikely, 40 (50%) participants preferred to receive treatment at home, 32 (40%) preferred in-hospital management, and 8 (10%) were unsure. Thirty-three patients (41%) expressed a desire for spiritual support, 38 (48%) said not and the remaining 9 (11%) were indifferent.

Discussion: Advance planning of end-of-life procedures and doctor-patient communication regarding these items remains poor and must be improved.

MeSH terms

  • Advance Care Planning*
  • Aged
  • Cardiopulmonary Resuscitation / psychology*
  • Choice Behavior
  • Communication
  • Female
  • Heart Failure / psychology*
  • Humans
  • Male
  • Patient Participation
  • Patient Satisfaction
  • Physician-Patient Relations
  • Quality of Life