Stability of Preferences for Treatment Among Nursing Home Residents

This study assessed the stability of nursing home residents' preferences for medical treatments. Thirty-seven nondemented, nondepressed residents were surveyed serially over a six-month period. Preferences were elicited for CPR, i.v. antibiotics, mechanical ventilation, and artificial nutrition. Subjects preferred more treatment for their current health concerns than for all hypothetical conditions (p = .001). Subjects disvalued indefinite artificial nutrition and mechanical ventilation compared to time-limited trials (p < .001). All preference changes were toward less intervention; residents preferred limited treatment. Most preferences remained stable. Residents clearly distinguished between time-limited and indefinite treatment, desired i.v. antibiotics and limited mechanical ventilation, and rejected most other treatments.