Age and Ageing Advance Access originally published online on January 28, 2007
Age and Ageing 2007 36(3):274-279; doi:10.1093/ageing/afl179
Medical information and surrogate designation: results of a prospective study in elderly hospitalised patients
1 AP-HP, Hôpital Albert Chenevier and Hôpital Henri-Mondor, Department of Internal and Geriatric Medicine; University Paris 12, Créteil, France
2 AP-HP, Hôpital Henri-Mondor, Surgical Intensive Care Unit; University Paris 12, Créteil, France
3 AP-HP, Hôpital Emile Roux, Geriatric Department, Limeil-Brevannes, France
4 Inserm, Centre d'Investigation Clinique de Créteil Hôpital Henri-Mondor; University Paris 12, Créteil, France
Address correspondence to: E. Paillaud. Tel: 331 49813070; Fax: 331 49813810. Email: Elena.Paillaud{at}ach.ap-hop-paris.fr
Objectives: to determine the preferences of French elderly inpatients concerning medical information and surrogate designation in life-threatening situations.
Methods: intention-to-act questionnaire was completed by two geriatricians during a patient interview in the week following admission in three geriatric units in France. The participants were elderly patients (
70 years) with adequate cognitive performance for decision making as assessed by the Mini Mental State Examination. The impact of socio-demographic factors, level of confidence in medical care, cognitive or physical disability on surrogate designation and amount of medical information expected were measured.
Measurements: Impact of socio-demographic factors, level of confidence in medical care, cognitive or physical disability on surrogate designation and amount of medical information expected.
Results: 426 consecutive elderly patients were recruited. 32.6% wanted to receive complete information about their care and 77% declared they would want to be informed if they were in a life-threatening situation. 4.5% reported they would not want any medical information. A family member was designated as surrogate by 73% of the patients. In 28%, a second surrogate was also designated, usually the family physician (22%) or a member of the hospital medical staff (10%). Polytomous logistic regression analysis was used to assess determinants of the amount of information expected and social and medical parameters. MMSE score, the presence of physical disability, a low level of confidence in medicine and the presence of children were identified as independent determinants of a high level of information expectation.
Conclusion: Elderly hospitalised patients expressed a strong desire to receive extensive information and were willing to designate a surrogate in a life-threatening situation. The surrogate was usually a family member alone or with another person, usually a practitioner.
Keywords: surrogacy, ethics, medical information, elderly
Received 11 June 2006; accepted in revised form 14 December 2006.