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, IV 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 IV antibiotics and limited mechanical ventilation, and rejected most other treatments.