![]() Whether a patient can no longer speak for him or herself or family members have a hard time describing what their loved one wants, nurses may face the breakdown of communication during the decision-making process. Clinicians can provide improved care to both patients and families with better understanding of surrogates' needs and experiences. Here are some of the most common issues you may face during end-of-life care: 1. Surrogates experienced long-term physical and psychological outcomes from being decision-makers.įunctioning as a surrogate decision-maker typically places great moral, emotional, and cognitive demands on the family surrogate. Group or consensual decision-making involving multiple family members was preferred over individual surrogate decision-making. Quality of communication available with providers significantly influenced family satisfaction with decision-making and EOL care. In qualitative explorations of their perspectives, family members voiced their desire to be involved and to accept the moral responsibility attendant to being a surrogate. Increased accuracy occurred in more extreme scenarios, under conditions of forced choice, and when the surrogate was specifically directed to use substituted judgment. Health care and end of life decision making crosses ethical, religious, cultural, emotional, legal, and policy areas. ![]() In studies using hypothetical scenarios to compare patients' choices and surrogates' predictions of those choices, surrogates demonstrated low to moderate predictive accuracy. among some of the most important decisions individuals and family members may face. Fifty-one studies focusing on family decision-making experiences, needs, and processes when assisting a dying family member were selected following electronic database searches and ancestry searches. End-of-life decision making among patients and proxies. Phillippine Journal of Internal Medicine. Garrard's (1999) methods for conducting a systematic review of the literature were followed. Family members’ satisfaction in the end-of-life care in the ICU in a tertiary hospital setting. To enhance understanding of the phenomenon of family surrogate decision-making at the end of life (EOL) by means of a systematic review and synthesis of published research reports that address this phenomenon.
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