Staff and Proxy Views of Multiple Family Member Involvement in Decision Making for Nursing Home Residents With Advanced Dementia

被引:1
|
作者
Roach, Ashley [1 ,6 ]
Rogers, Anita Hendrix [2 ]
Mitchell, Susan L. [3 ,4 ]
Mccarthy, Ellen P. [3 ,4 ]
Lopez, Ruth Palan [5 ]
机构
[1] Oregon Hlth & Sci Univ, Sch Nursing, Portland, OR USA
[2] Univ Tennessee, Dept Nursing, Martin, TN USA
[3] Hebrew SeniorLife, Hinda & Arthur Marcus Inst Aging Res, Boston, MA USA
[4] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Dept Med, Div Gerontol, Boston, MA USA
[5] MGH Inst Hlth Profess, Sch Nursing, Boston, MA USA
[6] Oregon Hlth & Sci Univ, Sch Nursing, 3455 SW US Vet Hosp Rd, Portland, OR 97239 USA
基金
美国国家卫生研究院;
关键词
Alzheimer disease; decision making; dementia; families; long-term care; qualitative; EXPERIENCES; MAKERS;
D O I
10.1097/NJH.0000000000000957
中图分类号
R47 [护理学];
学科分类号
1011 ;
摘要
Decision making for nursing home (NH) residents with Alzheimer disease and related dementias often involves input from multiple family members and NH staff to address goals of care at the end of life. Using data from the Assessment of Disparities and Variation for Alzheimer's disease Nursing home Care at End of life research study, a secondary analysis of qualitative data was conducted involving interviews of 144 NH staff and 44 proxies in 14 NHs to examine the perspectives of NH staff and proxies for NH residents with Alzheimer disease and related dementias on the involvement of multiple family members in decision making about end-of-life care decisions. Interviews took place between 2018 and 2021. Nursing home staff and proxies had differing perspectives of the involvement of multiple family members in decision making, with NH staff primarily viewing families as a source of conflict, whereas proxies viewed families as a source of support. Nursing home staff also had differing opinions of their role with families; some attempted to ameliorate conflict, and some did not get involved. Some NH staff felt that Black families had more conflict than White families, indicating unacceptable bias and stereotyping of Black families by NH staff. These findings suggest training and education is needed for NH staff to facilitate better communication with families and to support proxies in end-of-life decision making to address goals of care for NH residents with Alzheimer disease and related dementias.
引用
收藏
页码:263 / 270
页数:8
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