They do what they think is the best for me. Frail elderly patients' preferences for participation in their care during hospitalization

Objective: To deepen the knowledge of frail elderly patients' preferences for participation in medical decision making during hospitalization. Methods: Qualitative study using content analysis of semi-structured interviews. Results: Patient 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. Conclusion: The 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 implications: More 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. (C) 2009 Elsevier Ireland Ltd. All rights reserved.