The population of older adults in the United States is growing in size and diversity, presenting challenges to health care providers and patients in the context of health care decision making (DM), including obtaining informed consent for treatment, advance care planning, and deliberations about end-of-life care options. Although existing…

Presents review of perspectives from law, medical ethics, and psychosocial research to emphasize importance and multi-disciplinary nature of autonomy issues in long term care and to clarify background of Retirement Research Foundation's Personal Autonomy in Long Term Care Initiative. Introduces supplemental issue of "The Gerontologist"…

Mapped values of elders, family members or friends, and professionals involved in long-term care decision, based on 60 retrospective interviews. Language used to express values by elders and family members was expressive and particular, language of professionals was abstract and formulaic. Elders emphasized self-identity and environment whereas,…

Doctors making end-of-life medical care decisions for decisionally incapacitated older patients often rely on family in choosing what patient would have wanted. Used vignette-based study to examine ability of proxies to choose as patients reported they would have chosen. Discusses implications for use of advance directives for end-of-life care and…

To investigate empirical assumptions about substituted judgment, 3 treatment decision scenarios were presented to 43 competent elderly persons and 115 persons related to them. Related subjects who were explicitly asked to make substituted judgment came significantly closer to elderly person's preferences than those who were asked to make their…

Explores nature of physician decision making in the case of elderly who reside in the community. Interviews with 40 physicians revealed 3 dilemma sources: (1) how much to intervene in patients' lives to reduce risk; (2) structural, moral, and medical limits to patient advocacy; and (3) assessing vulnerability and quality of life when pondering…

Purpose: The identification of nursing home residents who can continue to participate in advance care planning about end-of-life care is a critical clinical and bioethical issue. This study uses high quality observational research to identify correlates of advance care planning in nursing homes, including objective measurement of capacity. Design…