A NEW HEALTH-CARE DIRECTIVE FOR LONG-TERM-CARE ELDERLY BASED ON PERSONAL VALUES OF LIFE

Determining the appropriate intensity of investigation and treatment f or individual elderly patients in long-term care settings can present a significant challenge to physicians, especially when patients are in competent to decide for themselves. However, respecting established in tervention levels may represent an even greater challenge, given the r ealities of coverage by on-call physicians, This paper describes a new Intervention Level Scale for competent as well as incompetent long-te rm care elderly, and its validation as a communication tool between at tending and on-call physicians. Specifically studied were (a) concorda nce of interventions, (b) whether prior knowledge of an intervention l evel by an on-call physician was considered useful, (c) applicability of the scale in different institutions and (d) necessity of physician training for optimal use. The scale's uniqueness resides in the fact t hat it is based on personal values of life, rather than institutional resources, and it incorporates directives on family contact.