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Decision-making and outcomes of prolonged ICU stays in seriously ill patients

Article Abstract:

Outcomes of prolonged intensive care unit (ICU) stays for seriously ill patients and the related decision-making are discussed. It was found in a prospective cohort study involving 9105 patients at five teaching hospitals that prolonged ICU stays are expensive and often followed by death or disability. Physician-patient discussions did not often take place according to patients. Many preferred palliative care and did not feel the care they received was in line with the preference, but it more often was if the preferences were discussed.

Author: Hamel, Mary Beth, Teno, Joan M., Wenger, Neil S., Lynn, Joanne, Wu, Albert W., Harrell, Frank E., Jr., Fisher, Elliot, Murphy, Donald J.
Publisher: Blackwell Publishers Ltd.
Publication Name: Journal of the American Geriatrics Society
Subject: Seniors
ISSN: 0002-8614
Year: 2000
Social aspects, Economic aspects, Laws, regulations and rules, Assisted suicide, Right to die, Intensive care units

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Elderly persons' last six months of life: findings from the Hospitalized Elderly Longitudinal Project

Article Abstract:

The last six months of life of elderly people have been investigated at four teaching hospitals in the Hospitalized Elderly Longitudinal Project (HELP). Subjects numbered 417, were older than 79 years, and died within a year of enrollment hospitalization. It was found that patients preferred comfort care, reported increasing functional impairments and had quality of life that was limited. A substantial number were in severe pain and most had no document or plan to limit aggressive life-prolonging care.

Author: Hamel, Mary Beth, Lynn, Joanne, Zhong, Zhenshao, Somogyi-Zalud, Emese
Publisher: Blackwell Publishers Ltd.
Publication Name: Journal of the American Geriatrics Society
Subject: Seniors
ISSN: 0002-8614
Year: 2000
Psychological aspects, Demographic aspects, Pain, Pain management, Palliative treatment, Palliative care, Death, Quality of life

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Subjects list: Health aspects, Aging, Care and treatment, Aged, Elderly, Research, United States, Management, Usage, Physician and patient, Physician-patient relations, Terminal care, Beliefs, opinions and attitudes, Ethical aspects, Hospitalization, Hospital patients, Medical care decision-making authority (Law), Medical care decision making authority (Law), Right to refuse treatment, Treatment refusal, CPR (First aid), Cardiopulmonary resuscitation, Hospital care, Frail elderly, Resuscitation, Bioethics, Living wills
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