ATTITUDES TOWARD LIFE-SUSTAINING TREATMENT OF OLDER PERSONS IN HONG-KONG

OBJECTIVES: There have been few studies of the attitudes of older Asia ns toward life-sustaining therapy. This paper presents the knowledge o f and attitudes toward cardiopulmonary resuscitation (CPR) and life su pport in a group of subjects in Hong Kong. DESIGN: Cross-sectional, de sciptive study. PARTICIPANTS: Of the 543 subjects, 382 were old-age ho me residents and 161 were in-patients of geriatric wards. MEASURMENTS: Sociodemographic data, functional ability (using the Barthel Index), self-perceived health scale, knowledge of life-sustaining procedures, and subjects' preferences for such treatments were studied. They were also asked to give the most important reason for wanting or declining CPR, and to indicate who they believe should be the decision-maker(s) regarding whether they should receive life-sustaining treatment. RESUL TS: Approximately 80% of old-age home residents and 60% of hospitalize d patients had no knowledge of life-sustaining therapy. The success ra te of CPR was overestimated by older subjects, and most wished to be r esuscitated. However, up to 20% changed their minds and declined CPR a fter they knew the true outcome of the procedure. Half of the subjects wanted life support. Univariate analysis found that advanced age and not having a spouse were associated significantly with CPR preference, whereas subjects' knowledge was associated with preference for life s upport. Multivariate analysis revealed that advanced age, not having a spouse, and female sex were independently associated with a tendency to decline CPR. A considerable proportion of older people wished to be involved in decision-making regarding life-sustaining treatment. CONC LUSION: Knowledge of life-sustaining procedures was poor among older p eople in Hong Kong compared with their counterparts in western countri es. Although most older subjects wanted CPR, a number of them changed their minds after they knew the poor outcome. Therefore, older patient s should be given more information about life-sustaining therapy and e ncouraged to take part in their treatment plans.