Purpose: This study examines the longitudinal patterns of Preparation for Future Care (PFC), defined as Awareness, Avoidance, Gathering Information, Decision Making, and Concrete Plans, in first-degree relatives of people with Alzheimer's disease (AD). Design and Methods: Eight time points across 6.5 years from a subsample of adults aged 70 years…

Purpose of the Study: I examine whether 5 aspects of a significant other's death quality (pain, decision-making capacity, location, problems with end-of life care, and preparation) affect whether one does advance care planning (ACP). I also identify specific aspects of others' deaths that respondents say triggered their own planning. Design and…

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…

Adults over the age of 65 years account for 60% of all hospital admissions and experience consequential negative outcomes directly related to hospitalization. Negative outcomes include falls, delirium, loss in ability to perform basic activities of daily living, and new walking dependence. New walking dependence, defined as the loss in ability to…

Purpose: This study explored the process of decision making about hospice enrollment and identified factors that influence the timing of that decision. Methods: This study employed an exploratory, descriptive, cross-sectional design and was conducted using qualitative methods. In-depth in-person semistructured interviews were conducted with 36…

Purpose: This study's purpose was to advance the process of culture change within long-term care (LTC) and assisted living settings by using participatory action research (PAR) to promote residents' competence and nourish the culture change process with the active engagement and leadership of residents. Design and Methods: Seven unit-specific PAR…

Purpose: We examined race/ethnicity and cultural context within hypothetical end-of-life medical decision scenarios and its influence on patient-proxy agreement. Design and Methods: Family dyads consisting of an older adult and 1 family member, typically an adult child, responded to questions regarding the older adult's preferences for…

The ethical primacy of patient involvement in treatment decision-making requires that more attention be paid to assessment of a patient's competency to make treatment decisions. Makes recommendations to increase sensitivity to this issue with significantly impaired elderly nursing home patients and to improve existing decision-making procedures.…

Purpose: This study examined patients' and surrogates' attitudes about using advance directives to manage end-of-life medical care. It also explored process preferences, or how patients want decisions to be made. Design and Methods: Data come from the third wave of the Advance Directives, Values Assessment, and Communication Enhancement project, a…

Purpose: This study was designed to examine the factors associated with the preferences of Alzheimer's disease patients to participate in a decision to use an Alzheimer's disease-slowing medication and how involved their caregivers would let them be in this decision. Design and Methods: Interviews were conducted with 48 patients in the…

Purpose: Advance directives are important planning and decision-making tools for individuals in nursing homes. Design and Methods: By using the nursing facility Minimum Data Set, we examined the prevalence of advance directives at admission and 12 months post-admission. Results: The prevalence of having any advance directive at admission declined…

Examined aspects of posthospital care decisions for elderly patients (N=314) being discharged. Found six dimensions of patients' perceptions of the decision making: certainty about outcomes, family support for decision making, restriction of choice, feeling of being rushed, control over the choice, and hypervigilance. (Author/ABL)

Assessed decision-making capability and preferences regarding advance directives of 39 nursing home residents and proxies. Most patients willingly stated preferences; over one-half opted to forego burdensome measures when death appeared imminent. Decisionally capable patients were more likely to forego life-sustaining measures than those of…

Presents model for interdisciplinary discharge planning team, with emphasis on functional status and improved coordination and continuity among providers. Describes design and implementation of such a program at university hospital. Explains how model resulted in more patients being discussed and served, with more emphasis on the functional…

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…