Elderly Patients' Preferences for Long-term Life Support

OBJECTIVE: To study elderly patients' preferences regarding mechanical ventilation and tube feeding and to compare their preferences for short-term use with their preferences for long-term use of these life support interventions. DESIGN: Interviews with patients by clinicians during routine office visits. SETTING: Hospital-based, primary care geriatrics clinic in downtown Denver, Colo. PATIENTS: Two hundred eighty-seven elderly persons (mean age, 77 years; range, 60-99 years). MAIN OUTCOME MEASURES: Preferences to use or withhold: (1) short-term mechanical ventilation; (2) long-term mechanical ventilation; (3) short-term tube feeding; and (4) long-term tube feeding. RESULTS: Of the total sample, 253 patients (88%) would prefer short-term mechanical ventilation if the chance of recovering was reasonably good but only 11 (3.5%) would prefer long-term mechanical ventilation. One hundred eighty-nine (65%) would prefer short-term tube feeding, but only 13 (4.5%) would prefer long-term tube feeding in the setting of significant cognitive impairment. CONCLUSIONS: Most elderly persons opt for short-term mechanical ventilation or tube feeding if the chance of recovering is reasonably good. Only a small minority would opt for long-term mechanical ventilation or tube feeding.