*For 1 person unknown if treatment was performed Problems with eating and drinking (n=77) Forgoing treatment in older people: are patient preferences being followed? P.J. Kaspers, MSc 1 H.R.W. Pasman, PhD 1 D.J.H. Deeg, PhD 2 B.D. Onwuteaka-Philipsen, PhD 1 1Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands 2Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Centre/LASA, Amsterdam, the Netherlands *For 1 or 2 person(s) unknown if treatment was performed Respiratory Insufficiency (n=45) BACKGROUND Population aging, combined with enhanced medical possibilities, confronts physicians more and more with the dilemma whether or not to perform life- prolonging treatment in older people. Research on the direct relationship between patient’s preferences and actual decision in practice have not been investigated in depth yet. OBJECTIVE The aim is to study whether preferences of older people on (non-) treatment are being followed in end-of-life decisions in the last three months of life. METHODS Written questionnaire Sample of proxy respondents of deceased participants of Longitudinal Aging Study Amsterdam (LASA, n=168) Sample of proxy respondents of deceased participants of Advance Directive Cohort (ADC, n=184) Life-prolonging treatments: resuscitation, artificial nutrition and fluids, antibiotics, artificial respiration Participants included in the analyses if a person got in a situation that one of 4 life-prolonging treatments had to be made RESULTS All Fig: actual decision taken and the relation with preferences (absolute n and rounded %); in italic if decision are in accordance with preference Cardiac Arrest (n=24) KNOWN PREF RESUSCITATION n=15 YES, DO RESUCITATE n= 2 (13%) RESUCITATION PERFORMED n= 2 (100%) NO RESUCITATION PERFORMED n= 0 (0 %) NO, DO NOT RESUCITATE n= 13 (87%) * RESUSCITATION PERFORMED n= 6 (50%) NO RESUCITATION PERFORMED n= 6 (50%) UNKNOWN PREF RESUCITATION n=9 * RESUCITATION PERFORMED n = 5 (63%) NO RESUCITATION PERFORMED n= 3 (38%) * p < 0.05 *For 1 person unknown if treatment was performed CONCLUSION This study shows that all four life-prolonging treatments that older people who prefer a treatment, a majority actually also received the treatment. In contrast, a considerable number of people who preferred not to be treated, received the treatment anyhow, especially for artificial respiration. Yet, people who preferred no treatment received no treatment more often than people with an unknown preference. This was confirmed in a multiple logistic regression on factors related to forgoing treatment. In conclusion, the study underlines that it is indeed usefull to make your preferences known. * p < 0.05 KNOWN PREFERENCE FOR ART. NUTRION AND FLUIDS n=44 YES, DO ADMINISTER ART. NUTRITION AND FLUIDS n= 26 (59%) ART. NUTRITION AND FLUIDS ADMINISTERED n= 23 (88%) NO NUTRITION AND FLUIDS ADMINISTERED n= 3 (12 %) NO, DO NOT ADMINISTER ART. NUTRITION AND FLUIDS n= 18 (41%) ART. NUTRITION AND FLUIDS ADMINISTERED n= 7 (40%) NO NUTRITION AND FLUIDS ADMINISTERED n= 11 (60%) UNKNOWN PREFERENCE n= 33 * ART. NUTRITION AND FLUIDS ADMINISTERED n= 19 (59%) NO NUTRITION AND FLUIDS ADMINISTERED n= 13 (41%) KNOWN PREFERENCES ANTIBIOTICS n=43 YES, DO ADMINISTER ANTIBIOTICS n= 38 (88%) * ANTIBIOTICS ADMINISTERED n= 33 (90%) NO ANTIBIOTICS ADMINISTERED n= 3 (10%) NO, DO NOT ADMINISTER ANTIBIOTICS n= 5 (12%) ANTIBIOTICS ADMINISTERED n= 2 (40%) NO ANTIBIOTICS ADMINISTERED n= 3 (60%) UNKNOWN PREFERENCES ANTIBIOTICS n=20 * ANTIBIOTICS ADMINISTERED n = 15 (79%) NO ANTIBIOTICS ADMINISTERED n= 4 (21%) KNOWN PREFERENCE IN ARTIFICAL RESPIRATION n=32 YES, DO ARTIFICIAL RESPIRATE n= 24 (75%) * ARTIFICIAL RESPIRATION PERFORMED n= 23 (100%) NO ARTIFICIAL RESPIRATION n= 0 (0%) NO, DO NOT ARTIFICIAL RESPIRATE n= 8 (25%) ARTIFICIAL RESPIRATION PERFORMED n= 7 (88%) NO ARTIFICIAL RESPIRATION n= 1 (12%) UNKNOWN PREFERENCE IN ARTIFICIAL RESPIRATION n=13 * ARTIFICIAL RESPIRATION PERFORMED n = 8 (67%) NO ARTIFICIAL RESPIRATION PERFORMED n= 4 (33%) Pneumonia (n=63) *For 1 person unknown if treatment was performed