Skip to main content

Advertisement

Log in

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

  • Published:
Ageing International Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Department of Health, United Kingdom. Available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Bulletins/theweek/Chiefexecutivebulletin/DH_4108436. Accessed March 21, 2011.

  • Dewar, M. A. (1994). Advance directives and treatment withdrawal: legal considerations. The Journal of the Florida Medical Association, 81, 22–26.

    Google Scholar 

  • Douglas, R., & Brown, H. N. (2002). Patients’ attitudes toward advance directives. Journal of Nursing Scholarship, 34, 61–65.

    Article  Google Scholar 

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.

    Article  Google Scholar 

  • Heo, D. S. (2009). Patient autonomy and advance directives in Korea. Journal of Korean Medical Association, 52, 865–870.

    Article  Google Scholar 

  • High, D. M. (1993). Advance directives and the elderly: a study of intervention strategies to increase use. Gerontologist, 33, 342–349.

    Article  Google Scholar 

  • Hoffmann, D. E., Zimmerman, S. I., & Tompkins, C. (1997). How close is enough? Family relationships and attitudes toward advance directives and life-sustaining treatments. Journal of ethics, law, and aging, 3, 5–24.

    Google Scholar 

  • Hopp, F. P., & Duffy, S. A. (2000). Racial variations in end-of-life care. Journal of American Geriatrics Society, 48, 658–663.

    Google Scholar 

  • Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., & Jaffe, M. W. (1963). Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association, 185, 914–919.

    Article  Google Scholar 

  • Laakkonen, M. L., Pitkala, K. H., Strandberg, T. E., Berglind, S., & Tilvis, R. S. (2004). Living will, resuscitation preferences, and attitudes towards life in an aged population. Gerontology, 50, 247–254.

    Article  Google Scholar 

  • Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179–186.

    Article  Google Scholar 

  • Lee, J., & Kim, K. H. (2010). Perspectives of Korean patients, families, physicians and nurses on advance directives. Asian Nursing Research, 4, 185–193.

    Article  Google Scholar 

  • McAdam, J. L., Stotts, N. A., Padilla, G., & Puntillo, K. (2005). Attitudes of critically ill Filipino patients and their families toward advance directives. American Journal of Critical Care, 14(1), 17–25.

    Google Scholar 

  • Miles, S. H., Koepp, R., & Weber, E. P. (1996). Advance end of- life treatment planning. A research review. Archives of Internal Medicine, 156(10), 1062–1068.

    Article  Google Scholar 

  • Molloy, D. W., Stiller, A. K., & Russo, R. (2000). Technology and educating seniors about advance directives. Educational Gerontology, 26, 357–369.

    Article  Google Scholar 

  • Rurup, M. L., Onwuteaka-Philipsen, B. D., Heide, A., Wal, G., & Deeg, D. J. (2006). Frequency and determinants of advance directives concerning end-of-life care in The Netherlands. Social Science & Medicine, 62, 1552–1563.

    Article  Google Scholar 

  • Samanta, A., & Samanta, J. (2006). Advance directives, best interests and clinical judgement: shifting sands at the end of Life. Clinical Medicine, 6(3), 274–278.

    Article  Google Scholar 

  • Schonwetter, R. S., Walker, R. M., & Robinson, B. E. (1995). The lack of advance directives among hospice patients. The Hospice Journal, 10(3), 1–11.

    Google Scholar 

  • Sheikh, S. K., & Yasavage, J. A. (1986). Geriatric depression scale (GDS): recent evidence and development of a shorter version. Clinical Gerontology. A Guide to Assessment and Intervention. NY. The Hawarth Press pp 165–173.

  • Wilson, D. M. (2000). End-of-life care preferences of Canadian senior citizens with caregiving experience. Journal of Advanced Nursing, 31, 1416–1421.

    Article  Google Scholar 

  • Winick, B. J. (1998). Client denial and resistance in the advance directive context: reflections on how attorneys can identify and deal with a psycho legal soft spot. Psychology, Public Policy, and Law, 4, 901–923.

    Article  Google Scholar 

Download references

Acknowledgment

This research was supported by Ain Shams University.

All authors have no financial or other relations that could lead to a conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mohamed S. Khater.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Amer, M.S., Khater, M.S., Elawam, A.E. et al. Attitudes of Elderly Egyptian Nursing Homes Residents Towards Advance Directives. Lack of Knowledge but Positive Attitudes. Ageing Int 40, 29–35 (2015). https://doi.org/10.1007/s12126-012-9156-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12126-012-9156-1

Keywords

Navigation