End of life treatment decisions in people with dementia: Carers' views andthe factors which influence them

Objective. Treatment decisions in life threatening situations (TD) are poor ly studied in people with dementia. Method. The carers of people with dementia were asked four TD questions, pe rtaining to cardiac resuscitation, intravenous fluids, oral antibiotics and intravenous antibiotics. The impact of key variables (age, dementia severi ty, psychiatric co-morbidity, physical illness, family relationship of care r) on TD were evaluated. Results. Fifty carers participated, 46% wanted cardiac resuscitation, 60% w anted treatment with intravenous fluids, 52% wanted treatment with intraven ous antibiotics and 60% wanted treatment with oral antibiotics. Agreement b etween questions was high (76-89%), suggesting that relatives were either f or or against intervention. There was an association between more severe de mentia and a reduced wish for intravenous antibiotics. None of the variable s significantly influenced other TD. Conclusion. The 'global' view of carers, was not influenced greatly by key disease variables. There are potential implications for the way in which ca rers are used as proxy decision makers. Copyright (C) 2000 John Wiley & Son s, Ltd.