Elderly people's thoughts about surrogate decision making in end-of-life care : Increasing trust through communication in the primary care
10.14442/generalist.39.150
- VernacularTitle:終末期の延命治療に対する代理意思決定 : 高齢者の認識と課題
- Author:
Nobuyuki Maki
;
Kazue Kosugi
;
Tomoka Nagashima
;
Misuzu Nakamura
- Publication Type:Journal Article
- Keywords:
end-of-life care;
life-sustaining treatment;
surrogate decision making;
elderly people;
reason
- From:An Official Journal of the Japan Primary Care Association
2016;39(3):150-156
- CountryJapan
- Language:Japanese
-
Abstract:
Introduction : The purpose of this study was to approach issues related to end-of-life care by investigating elderly people's own thoughts about surrogate decision making by family members.
Methods : Semi-structured interviews were carried out with 30 elderly people 60 years of age and older to determine whether or not they trust in surrogate decision making by their family members, and to examine the reasons for their thoughts. Each of the respondents' statements were categorized by level of confidence, and their reasons were analyzed.
Results : Respondents were divided into two main groups : a “trusting” group and an “anxious” group. Seventy percent of respondents were in the “trusting” group. In both groups, the most common reason given was related to the desire to directly communicate one's wishes to one's surrogates. Following that, in the “trusting group”, the main reasons were related to the thoughts of the interviewee and the characteristics of the surrogates. In the “anxious group”, the main reasons were issues of end-of-life care related to the feelings of surrogates, the attitude of medical staff, and other background factors.
Conclusion : To resolve issues of surrogate decision making related to end-of-life care, it is important in primary care practice to provide encouragement and support to elderly people to allow them to clearly communicate their wishes. We recommend further study and ethical discussion about end-of-life care to establish appropriate legal and institutional frameworks.
