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Educating the Elderly: Cardiopulmonary Resuscitation Decisions before and after Intervention
Author(s) -
Schonwetter Ronald S.,
Teasdale Thomas A.,
Taffet George,
Robinson Bruce E.,
Luchi Robert J.
Publication year - 1991
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1991.tb02902.x
Subject(s) - medicine , cardiopulmonary resuscitation , marital status , intervention (counseling) , depression (economics) , ambulatory , logistic regression , geriatric depression scale , resuscitation , emergency medicine , family medicine , depressive symptoms , cognition , nursing , psychiatry , population , environmental health , economics , macroeconomics
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 = 0.05) 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 r 2 = 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.