*For 1 person unknown if treatment was performed Problems with eating and drinking (n=77)

1. Forgoing treatment in older people: are patient preferences being followed? P.J. Kaspers, MSc1 H.R.W. Pasman, PhD1 D.J.H. Deeg, PhD2 B.D. Onwuteaka-Philipsen, PhD1 1Department of Public and Occupational Health,EMGOInstitute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands 2Department of Psychiatry, EMGOInstitute for Health and Care Research, VU University Medical Centre/LASA, Amsterdam, the Netherlands p.kaspers@vumc.nl 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) Pneumonia (n=63) *For 1 or 2 person(s) unknown if treatment was performed Respiratory Insufficiency (n=45) * p < 0.05 * p < 0.05 *For 1 person unknown if treatment was performed Problems with eating and drinking (n=77) *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. *For 1 person unknown if treatment was performed