Amyotrophic lateral sclerosis and life-sustaining therapy: patients' desires for information, participation in decision making, and life-sustaining therapy.

Abstract:

:To identify the wishes of patients with amyotrophic lateral sclerosis (ALS) for information, participation in decision making, and life-sustaining therapy and to determine whether these wishes are stable over time, we conducted a prospective survey (baseline and 6-month follow-up interviews) of 38 consecutive patients with an established diagnosis of ALS at the University of Chicago Motor Neuron Disease Clinic. Demographic data, clinical stage of ALS, illness experience, wishes for information, and desires for participating in decisions about life-sustaining therapy were elicited. Patients readily expressed their wishes for specific information on communication aids and ventilator care for respiratory failure. Demographic, socioeconomic, and clinical characteristics did not predict patients' desires for information and decision making. The preferences for information and participation in decisions were stable during the 6-month study period, whereas preferences for cardiopulmonary resuscitation in two hypothetical circumstances were less stable. Changes were unrelated to demographic or clinical characteristics of the patients. Because many patients with ALS change their preferences for life-sustaining therapy, advance directives for end-of-life care must be reevaluated periodically.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

Silverstein MD,Stocking CB,Antel JP,Beckwith J,Roos RP,Siegler M

doi

10.1016/s0025-6196(12)61577-8

subject

Has Abstract

pub_date

1991-09-01 00:00:00

pages

906-13

issue

9

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(12)61577-8

journal_volume

66

pub_type

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