scholarly journals Eudaimonic Testimonial Vs. Didactic Presentation Impact on Willingness to Engage in Conversations about End-of-Life Care: The Moderating Role of Modeling

2021 ◽  
pp. 1-10
Author(s):  
Judy Watts ◽  
Michael D. Slater
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Moderating Role ◽  
Didactic Presentation ◽  
Willingness To Engage

End of life care in the community: the role of ambulance clinicians

2013 ◽  
Vol 5 (7) ◽  
pp. 394-399 ◽  
Author(s):  
Annie Pettifer ◽  
Rosanna Bronnert
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care

scholarly journals Continuation of end-of-life care in a special elderly nursing home and the role of doctors

2012 ◽  
Vol 49 (3) ◽  
pp. 336-343
Author(s):  
Akira Kurita ◽  
Naosuke Shinagawa ◽  
Eitarou Kodani ◽  
Shinichirou Iwahara ◽  
Bonpei Takase ◽  
...  
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care

False Expectations? Expectations vs. Probabilities for Dying

2000 ◽  
Vol 41 (3) ◽  
pp. 157-185 ◽  
Author(s):  
Carolyn M. Smith
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Living Will ◽  
Ethnographic Study ◽  
Life Care ◽  
Patient Attitudes ◽  
Affected Patient ◽  
Catastrophic Illness ◽  
Physician Relationship

It is widely recognized that the role of the physician has undergone dramatic changes in the last century—changes which have serious implications for the patient-physician relationship. This is an ethnographic study examining how certain changes in the role and abilities of biomedical physicians have affected patient attitudes and expectations about end-of-life care. In-home interviews were conducted with eighteen persons age fifty-five and older, including a sample of Hemlock Society members. Results indicate a broad spectrum of end-of-life concerns including capacity, autonomy, pain, and burden to loved ones. Most participants reported a reluctance to begin a discussion of death or future deteriorating capacity with their physicians. Instead, when conversations about death were reported, they had been largely limited to the scenarios of catastrophic illness (e.g., hospitalization, ventilator, etc.) and the Living Will. While this discussion does not overlook the utility of the Living Will, it proposes that reliance on this document for preparing patients for end-of-life care is inadequate.

scholarly journals P142: Gaps in public preparedness to be a substitute decision maker and the acceptability of high school education on resuscitation and end-of-life care: a mixed-methods study

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S115-S116
Author(s):  
M. Wong ◽  
M. Medor ◽  
K. Yelle Labre ◽  
M. Jiang ◽  
J. Frank ◽  
...  
Keyword(s):  
High School ◽  
Mixed Methods ◽  
Critical Illness ◽  
End Of Life ◽  
Decision Maker ◽  
End Of Life Care ◽  
High School Education ◽  
Life Care ◽  
Substitute Decision Maker

Introduction: When a patient is incapable of making medical decisions for themselves, choices are made according to the patient's previously expressed, wishes, values, and beliefs by a substitute decision maker (SDM). While interventions to engage patients in their own advance care planning exist, little is known about public readiness to act as a SDM on behalf of a loved one. This mixed-methods survey aimed to describe attitudes, enablers and barriers to preparedness to act as a SDM, and support for a population-level curriculum on the role of an SDM in end-of-life and resuscitative care. Methods: From November 2017 to June 2018, a mixed-methods street intercept survey was conducted in Ottawa, Canada. Descriptive statistics and logistic regression analysis were used to assess predictors of preparedness to be a SDM and understand support for a high school curriculum. Responses to open-ended questions were analyzed using inductive thematic analysis. Results: The 430 respondents were mostly female (56.5%) with an average age of 33.9. Although 73.0% of respondents felt prepared to be a SDM, 41.0% of those who reported preparedness never had a meaningful conversation with loved ones about their wishes in critical illness. The only predictors of SDM preparedness were the belief that one would be a future SDM (OR 2.36 95% CI 1.34-4.17), and age 50-64 compared to age 16-17 (OR 7.46 95% CI 1.25-44.51). Thematic enablers of preparedness included an understanding of a patient's wishes, the role of the SDM and strong familial relationships. Barriers included cultural norms, family conflict, and a need for time for high stakes decisions. Most respondents (71.9%) believed that 16 year olds should learn about SDMs. They noted age appropriateness, potential developmental and societal benefit, and improved decision making, while cautioning the need for a nuanced approach respectful of different maturity levels, cultures and individual experiences. Conclusion: This study reveals a concerning gap between perceived preparedness and actions taken in preparation to be an SDM for loved ones suffering critical illness. The results also highlight the potential role for high school education to address this gap. Future studies should further explore the themes identified to inform development of resources and curricula for improved health literacy in resuscitation and end-of-life care.

Family communication and decision making at the end of life: A literature review

2014 ◽  
Vol 13 (3) ◽  
pp. 815-825 ◽  
Author(s):  
Cara L. Wallace
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Family Communication ◽  
End Of Life Care ◽  
Family Members ◽  
Empirical Literature ◽  
Future Research ◽  
Life Care ◽  
The Family

AbstractObjective:Patients and families coping with a terminal illness are faced with a number of decisions over the course of their disease. The role that family communication plays in the process of decision making is an important one. The objectives for this review are to examine the current state of empirical literature on the relationship between family communication and decision making about end-of-life care, to identify gaps, and to discuss implications for policy, practice, and future research.Method:Articles were identified using systematic keyword searches within the following relevant databases: Academic Search Complete, CINAHL Plus, Communications and Mass Media Complete, ERIC, PsychINFO, MEDLINE, SocINDEX, and ProQuest.Results:The three bodies of relevant literature that emerged during this review include: (1) the importance of family communication at the end of life (EoL); (2) family decision making at the EoL; and (3) the interrelationship of communication (both within the family and with healthcare professionals) and decision making at the EoL. While the literature highlights the role of communication between medical professionals and the patient or family members, there is very little focus on the process of how family communication among the family members themselves contributes to decision making at the end of life.Significance of results:Barriers to end-of-life care are important considerations for helping patients to access timely and appropriate services. Understanding the pertinent role of family communication as it relates to the decision for EoL care is the first step in working to provide another avenue for overcoming these barriers.

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