Medical Decisions Made by Surrogates for Persons with Advanced Dementia within Weeks or Months of Death.

Peter V Rabins, Kathryn L Hicks, Betty S Black
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Abstract

Background: Surrogates make all medical decisions for persons with advanced dementia. This study describes the types of medical decisions that surrogates faced prior to the person's death and their perceived difficulty and satisfaction with those decisions.

Methods: Seventy-six surrogates of nursing home residents meeting hospice criteria for dementia were followed longitudinally and interviewed following the death of the person with dementia.

Results: The most common decisions made were related to transfer to hospital, diagnostic testing, and placement of a feeding tube. Surrogates perceived decisions to not treat to be more difficult than decisions to treat.

Conclusions: Surrogates frequently are faced with making medical decisions for persons with advanced dementia near the end of life. Clinicians can help surrogates by acknowledging the difficulty of making decisions to not treat.

晚期痴呆症患者在死亡前几周或几个月内由代理人做出的医疗决定。
背景:晚期痴呆症患者的所有医疗决定均由代理人做出。本研究描述了代治者在患者去世前所面临的医疗决定的类型,以及他们对这些决定所感受到的困难和满意度:方法:在痴呆症患者去世后,对符合临终关怀痴呆症标准的76名养老院居民的代理人进行了纵向跟踪和访谈:最常见的决定与转院、诊断检测和放置喂食管有关。代治者认为不治疗的决定比治疗的决定更困难:代治者经常面临为临终的晚期痴呆患者做出医疗决定的问题。临床医生可以通过承认做出不治疗决定的难度来帮助代治者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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