How do surrogates make treatment decisions for patients with dementia: An experimental survey study.

Autor: Nicholas LH; University of Colorado, Aurora, Colorado, USA., Langa KM; University of Michigan, Ann Arbor, Michigan, USA., Halpern SD; University of Pennsylvania, Philadelphia, Pennsylvania, USA., Macis M; Johns Hopkins University, Baltimore, Maryland, USA.
Jazyk: angličtina
Zdroj: Health economics [Health Econ] 2024 Jun; Vol. 33 (6), pp. 1211-1228. Date of Electronic Publication: 2024 Feb 15.
DOI: 10.1002/hec.4810
Abstrakt: Despite the growing need for surrogate decision-making for older adults, little is known about how surrogates make decisions and whether advance directives would change decision-making. We conducted a nationally representative experimental survey that cross-randomized cognitive impairment, gender, and characteristics of advance care planning among hospitalized older adults through a series of vignettes. Our study yielded three main findings: first, respondents were much less likely to recommend life-sustaining treatments for patients with dementia, especially after personal exposure. Second, respondents were more likely to ignore patient preferences for life-extending treatment when the patient had dementia, and choose unwanted life-extending treatments for patients without dementia. Third, in scenarios where the patient's wishes were unclear, respondents were more likely to choose treatments that matched their own preferences. These findings underscore the need for improved communication and decision-making processes for patients with cognitive impairment and highlight the importance of choosing a surrogate decision-maker with similar treatment preferences.
(© 2024 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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