End-of-life preferences in elderly patients admitted for heart failure.
BACKGROUND
Heart failure is increasing in prevalence and incidence, with considerable mortality among the elderly.


OBJECTIVE
To determine preferences concerning cardiopulmonary-resuscitation (CPR) and end-of-life care in elderly patients hospitalized for heart failure.


METHODS
Prospective interview-based survey.


METHODS
Patients >64 years old admitted for acute heart failure were interviewed to address their preferences regarding end-of-life care and cardio-pulmonary resuscitation (CPR) when facing the last stages of their disease.


RESULTS
We interviewed 80 patients (mean age 79 years; 58% women). Thirty-two (40%) expressed a wish not to have CPR. Only two had previously discussed their CPR preferences with their physicians. When recovery from the illness was considered unlikely, 40 (50%) participants preferred to receive treatment at home, 32 (40%) preferred in-hospital management, and 8 (10%) were unsure. Thirty-three patients (41%) expressed a desire for spiritual support, 38 (48%) said not and the remaining 9 (11%) were indifferent.


CONCLUSIONS
Advance planning of end-of-life procedures and doctor-patient communication regarding these items remains poor and must be improved.
Formiga
F
F
Geriatric Unit - Internal Medicine Service, Hospital Universitari de Bellvitge 'Princeps d'Espanya', L'Hospitalet de Llobregat 08907, Barcelona, Spain. fformiga@csub.scs.es
Chivite
D
D
Ortega
C
C
Casas
S
S
Ramón
J M
JM
Pujol
R
R
D032722:Advance Care Planning; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000523:psychology*; D002755:Choice Behavior; D003142:Communication; D005260:Female; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D008297:Male; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011788:Quality of Life