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The Decision to Execute a Durable Power of Attorney for Health Care and Preferences Regarding the Utilization of Life-Sustaining Treatments in Nursing Home Residents

Jiska Cohen-Mansfield, PhD; Beth A. Rabinovich, PhD; Steven Lipson, MD; Adele Fein, MSW; Barbara Gerber, MSW; Shulamith Weisman, MA; L. Gregory Pawlson, MD, MPH
Arch Intern Med. 1991;151(2):289-294. doi:10.1001/archinte.1991.00400020053012.
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One hundred three nursing home residents were interviewed regarding their preferences for the choice of an agent for health-care decision making while being offered the opportunity to execute a Durable Power of Attorney for health care. They also completed a questionnaire that tapped their preferences regarding the use of four types of life-support treatment under three hypothetical levels of future cognitive functioning. Factors that might influence these preferences, such as previous experiences with life-sustaining treatments, religious beliefs, and personal values, were also examined. Participants tended to choose their son or daughter as their agent for future health-care decision making. They had clear and consistent patterns of preferences regarding the utilization of life-sustaining treatment. Generally, participants opted not to be treated, although there was variability among participants. They were even less inclined to opt for treatment as their perceived level of future cognitive functioning declined, or when the life-sustaining treatment involved permanent rather than temporary procedures.

(Arch Intern Med. 1991;151:289-294)


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