Attitudes of Elderly Egyptian Nursing Homes Residents Towards Advance Directives. Lack of Knowledge but Positive Attitudes

Abstract

This study aimed to examine the attitude of elderly Egyptians living in nursing homes in Cairo to advance directives (ADs). A cross-sectional study was conducted and included a sample of 137 participants (60 years and above) from four nursing homes. The majority of them had never heard about ADs before. One hundred and twelve (81.8 %) showed an interest in ADs. The positive attitude toward ADs was associated with higher level of education, advancing age, sensory impairment, polypharmacy, those with functional dependency, and a greater number of existing co-morbidities. Nineteen participants (13.9 %) wanted a proxy for medical decisions, 18 (13.1 %) for financial matters and 75 (54.7 %) for both medical and financial issues. Regarding preferences for life-sustaining treatments; 63 (56.3 %) stated that they would refuse cardiopulmonary resuscitation, and 57 (50.9 %) would refuse mechanical ventilation if they were in an irreversible or incurable persistent vegetative state. Only 32 (28.6 %) participants accepted the idea of organ donation after death. This positive attitude for ADs among this sector of population may encourage the introduction of appropriate policies to facilitate the implementation of ADs among the elderly in Egypt.