Medical information and surrogate designation: results of a prospective study in elderly hospitalised patients.
OBJECTIVE
To determine the preferences of French elderly inpatients concerning medical information and surrogate designation in life-threatening situations.


METHODS
Intention-to-act questionnaire was completed by two geriatricians during a patient interview in the week following admission in three geriatric units in France. The participants were elderly patients (> or =70 years) with adequate cognitive performance for decision making as assessed by the Mini Mental State Examination. The impact of socio-demographic factors, level of confidence in medical care, cognitive or physical disability on surrogate designation and amount of medical information expected were measured.


METHODS
Impact of socio-demographic factors, level of confidence in medical care, cognitive or physical disability on surrogate designation and amount of medical information expected.


RESULTS
426 consecutive elderly patients were recruited. 32.6% wanted to receive complete information about their care and 77% declared they would want to be informed if they were in a life-threatening situation. 4.5% reported they would not want any medical information. A family member was designated as surrogate by 73% of the patients. In 28%, a second surrogate was also designated, usually the family physician (22%) or a member of the hospital medical staff (10%). Polytomous logistic regression analysis was used to assess determinants of the amount of information expected and social and medical parameters. MMSE score, the presence of physical disability, a low level of confidence in medicine and the presence of children were identified as independent determinants of a high level of information expectation.


CONCLUSIONS
Elderly hospitalised patients expressed a strong desire to receive extensive information and were willing to designate a surrogate in a life-threatening situation. The surrogate was usually a family member alone or with another person, usually a practitioner.
Paillaud
Elena
E
AP-HP, Hôpital Albert Chenevier and Hôpital Henri-Mondor, Department of Internal and Geriatric Medicine, University Paris 12, Créteil, France. Elena.Paillaud@ach.ap-hop-paris.fr
Ferrand
Edouard
E
Lejonc
Jean-Louis
JL
Henry
Olivier
O
Bouillanne
Olivier
O
Montagne
Olivier
O
D016223:Advance Directives / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D005602:France / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D016743:Mental Competency; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D010358:Patient Participation / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011446:Prospective Studies; D019727:Proxy / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D020458:Third-Party Consent / Q000706:statistics & numerical data