title: Preferences of elderly cancer patients in their advance directives.
abstract: Efforts to improve the quality of end-of-life decision-making have emphasized the principle of individual autonomy to better ensure that patients receive care consistent with their preferences. Advance directives (ADs) can be vehicles for in-depth and ongoing discussions among health care professionals, patients, and families. The aim of our study was to identify preferences and values expressed in ADs of 50 elderly patients with cancer. Main concerns of the patients were resuscitation and introduction of artificial nutrition. Very few patients had unrealistic expectation. Preferences about patient's symptom management were quite different from one to another. Content of ADs not only involved life-sustaining technology, but also psychosocial items and religious beliefs and values. All patients designated at least one surrogate. In conclusion, ADs should not be considered simply as another questionnaire, but more as a process to improve communication.
authors.affiliation: Palliative Medicine Division, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Switzerland. sophie.pautex@hcuge.ch
authors.forename: Sophie
authors.initials: S
authors.lastname: Pautex
authors.forename: Grigorios
authors.initials: G
authors.lastname: Notaridis
authors.forename: Laurence
authors.initials: L
authors.lastname: Déramé
authors.forename: Gilbert B
authors.initials: GB
authors.lastname: Zulian
mesh_terms: D016223:Advance Directives; D000368:Aged; D000369:Aged, 80 and over; D002755:Choice Behavior; D003142:Communication; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010166:Palliative Care; D057240:Patient Preference; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D019727:Proxy; D012067:Religion; D012189:Retrospective Studies; D013727:Terminal Care