Cardiopulmonary resuscitation and other life supporting measures in elderly patients: Attitudes of psychiatrists and geriatricians

Abstract

Survival following CPR in patients with dementia is very poor (0-4%). We set out to investigate whether there are differences between geriatricians and old age psychiatrists in their attitudes to resuscitation of hospitalized elderly patients with and without dementia. Our hypothesis was that the decision whether or not to resuscitate is influenced not only by the patient's characteristics but also by the doctor's characteristics. A questionnaire was distributed to 1,134 geriatricians on the list of the British Geriatric Society and to 879 old age psychiatrists on the list of the Royal College of Psychiatrists; 784 (39%) doctors replied and of these, 712 had analyzable data (418 geriatricians and 294 old age psychiatrists). Geriatricians' estimates of survival rates for CPR of elderly were more realistic. Old age psychiatrists (50%) were more likely than geriatricians (32%) to resuscitate cognitively intact patients with chronic ill health. Although the majority of doctors from both specialities favoured less invasive methods of treatment of patients with severe dementia, nevertheless more old age psychiatrists (14.3%) than geriatricians (9.4%) would consider invasive methods of treatment. Decisions about resuscitation are influenced not only by the characteristics of individual patients but also by the speciality of the doctor.