Educating the Elderly: Cardiopulmonary Resuscitation Decisions before and after Intervention

Ronald S. Schonwetter, Thomas A. Teasdale, George Taffet, Bruce E. Robinson, Robert J. Luchi

Research output: Contribution to journalArticle

81 Scopus citations

Abstract

Considering the limited success of cardiopulmonary resuscitation (CPR) in achieving survival to hospital discharge in older persons, it is appropriate to educate, discuss and determine patients' wishes at a time when they are able. Sixty-four ambulatory, non-depressed, non-demented veterans >74 years of age were interviewed and educated. Knowledge of CPR at baseline was variable, and most overestimated their survival chances. Most subjects desired routine CPR discussions with physicians. Only 17% had previously discussed their CPR preferences, and none had done so with physicians. Knowledge of CPR increased (P = 0.01) after educational intervention. There was no change in subjects' CPR decisions after education and presentation of current CPR outcome data. In considering five hypothetical scenarios, 9% never wanted CPR, and 17% always wanted CPR. Those who never wanted CPR were more realistic about their suspected survival chance (P = 0.003) and had higher educational levels (P = 0.03) Folstein (P = 0.03) and Geriatric Depression Scale (P = 0.04) scores. With the dependent variable being the number of hypothetical situations in which the patient desired CPR, a regression analysis (adjusted r2 = 0.72) limited significant variables to the patient's current CPR decision, Folstein score, religion, marital status, and previous ICU admissions. This study emphasizes that most elderly male veterans are willing and want to discuss their CPR attitude with physicians and that most have fixed CPR decisions which may be elicited under stable clinical conditions.

Original languageEnglish (US)
Pages (from-to)372-377
Number of pages6
JournalJournal of the American Geriatrics Society
Volume39
Issue number4
DOIs
StatePublished - Jan 1 1991

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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