• Anne W Ekdahl, Lars Andersson, and Maria Friedrichsen.
• Geriatric Department, Vrinnevi Hospital, Norrköping, Sweden; Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Norrköping, Sweden. anne.ekdahl@lio.se
• Patient Educ Couns. 2010 Aug 1; 80 (2): 233-40.

ObjectiveTo deepen the knowledge of frail elderly patients' preferences for participation in medical decision making during hospitalization.MethodsQualitative study using content analysis of semi-structured interviews.ResultsPatient participation to frail elderly means information, not the wish to take part in decisions about their medical treatments. They view the hospital care system as an institution of power with which they cannot argue. Participation is complicated by barriers such as the numerous persons involved in their care who do not know them and their preferences, differing treatment strategies among doctors, fast patient turnover in hospitals, stressed personnel and linguistic problems due to doctors not always speaking the patient's own language.ConclusionThe results of the study show that, to frail elderly patients, participation in medical decision making is primarily a question of good communication and information, not participation in decisions about medical treatments.Practice ImplicationsMore time should be given to thorough information and as few people as possible should be involved in the care of frail elderly. Linguistic problems should be identified to make it possible to take the necessary precautions to prevent negative impact on patient participation.Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

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