[Elderly outpatients' attitudes toward care in terminal stage disease].
Responses to a questionnaire regarding 1) dying at home, 2) being told of a diagnosis of cancer, and 3) hydration and nutrition, uses of narcotics for pain and dyspnea, oxygen treatment, antibiotics, transfusion and surgery in a near-vegetative state was obtained from 562 outpatients (73.4 +/- 8.6 years:mean +/- SD, men:women = 1.0:1.7). Dying at home was preferred by 64% and hospital death by 24%. Sixty and 65% of patients chose to be told of the diagnosis either in the last 3 months or at the early curable stage of the disease respectively, while only 53% wanted to be told precisely about their remaining estimated survival. If their spouse had terminal stage disease, 42% chose to inform the spouse of the diagnosis. Eighty percent chose palliative care, while 9.3% wished for intensive life-sustaining treatment. In a near vegetative state, tube feeding was desired by 8.7% and intravenous drip infusion by 39%; narcotics for pain or dyspnea were desired by 40 and 52%; oxygen or tracheostomy plus a respirator for dyspnea was chosen in 56 and 11% respectively; antibiotics for treatment of infection was desired by 38%; surgery for intestinal obstruction by 36 percent; transfusion for bleeding by 29%; and no treatment in any situation by 21%. Commonly expressed wishes were for a natural death, dying at home, and being told of the status of their disease, while details of palliative care were not well recognized.
Matsushita
S
S
Tokyo Metropolitan Geriatric Hospital.
Inamatsu
T
T
Hashimoto
H
H
Takahashi
R
R
Takahashi
T
T
Mori
M
M
Kida
K
K
Ozawa
T
T
D000368:Aged / Q000523:psychology*; D001293:Attitude to Death; D005260:Female; D006801:Humans; D007564:Japan; D008020:Life Support Care; D008297:Male; D010045:Outpatients / Q000523:psychology*; D011795:Surveys and Questionnaires; D013727:Terminal Care