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Responses to a questionnaire regarding 1) dying at home, 2) being told of a diagnosis of cancer, and 3) hydration and nutrition, uses of narcotics for pain and dyspnea, oxygen treatment, antibiotics, transfusion and surgery in a near-vegetative state was obtained from 562 outpatients (73.4 +/- 8.6 years:mean +/- SD, men:women = 1.0:1.7). Dying at home was preferred by 64% and hospital death by 24%. Sixty and 65% of patients chose to be told of the diagnosis either in the last 3 months or at the early curable stage of the disease respectively, while only 53% wanted to be told precisely about their remaining estimated survival. If their spouse had terminal stage disease, 42% chose to inform the spouse of the diagnosis. Eighty percent chose palliative care, while 9.3% wished for intensive life-sustaining treatment. In a near vegetative state, tube feeding was desired by 8.7% and intravenous drip infusion by 39%; narcotics for pain or dyspnea were desired by 40 and 52%; oxygen or tracheostomy plus a respirator for dyspnea was chosen in 56 and 11% respectively; antibiotics for treatment of infection was desired by 38%; surgery for intestinal obstruction by 36 percent; transfusion for bleeding by 29%; and no treatment in any situation by 21%. Commonly expressed wishes were for a natural death, dying at home, and being told of the status of their disease, while details of palliative care were not well recognized.

Elderly Outpatients' Attitudes toward Care in Terminal Stage Disease.