THE EFFECT OF HOSPITAL ADMISSION ON THE OPINIONS AND KNOWLEDGE OF ELDERLY PATIENTS REGARDING CARDIOPULMONARY-RESUSCITATION

Objective: to determine (i) if the opinions of elderly people, regardi ng their wish for cardiopulmonary resuscitation (CPR), change after st aying 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 in patients (63% of all admissions) without a terminal illness who could give informed consent, interviewed after hospital admission. Sixty-sev en were interviewed again at hospital discharge and three were intervi ewed 16-35 days after admission. Intervention: patient education and s emi-structured questionnaire. Outcome measures: patients' knowledge an d opinions on basic knowledge of CPR, preference for CPR, who should d ecide and how this should be documented. Results: knowledge improved a fter intervention, although patients persistently overestimated the su ccess rate of CPR. Eighty percent on admission and 69% following a hos pital stay wished to have CPR if necessary. Men were more likely to wa nt 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-fo ur percent felt comfortable with the interview. Conclusions: elderly p eople wish to be consulted about CPR but many do not wish their prefer ence to be committed to paper. Most older patients want CPR but these wishes may change with time. It is important that any recorded directi ve from a patient is updated frequently.