Emergency medical services providers' perspective of end‐of‐life decision making for people with intellectual disabilities

2017 ◽  
Vol 30 (6) ◽  
pp. 1057-1064 ◽  
Author(s):  
Jacqueline McGinley ◽  
Deborah P Waldrop ◽  
Brian Clemency
Keyword(s):  
Decision Making ◽  
Intellectual Disabilities ◽  
Emergency Medical Services ◽  
End Of Life ◽  
Medical Services ◽  
Emergency Medical ◽  
People With Intellectual Disabilities ◽  
End Of Life Decision ◽  
Life Decision

scholarly journals MANAGING DEATH IN THE FIELD: HOW EMERGENCY MEDICAL SERVICES TEAMS PROVIDE END-OF-LIFE CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S499-S499
Author(s):  
Deborah P Waldrop ◽  
Jacqueline M McGinley ◽  
Brian M Clemency
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Emergency Medical Services ◽  
End Of Life ◽  
End Of Life Care ◽  
Medical Services ◽  
Life Care ◽  
Serious Illness ◽  
Emergency Medical ◽  
Seriously Ill

Abstract Emergency medical services (EMS) providers respond more frequently to calls for older adults with serious illness than for people in other age groups. Recent legislation that makes it possible to document healthcare decisions has facilitated an era of choice in end-of-life care. EMS teams make time-sensitive decisions about care, resuscitation and hospital transport that influence how and where a seriously ill older adult will die and how his/her family will experience the death. Yet, EMS providers’ perspectives on urgent decision-making and how they work with families are unknown. The purpose of this study was to explore the decision-making process that occurs how EMS teams respond when someone is dying from a serious illness (vs. an injury). In-depth in-person interviews were conducted with 50 EMS providers (24 emergency medical technicians [EMTs] and 26 Paramedics) from four ambulance services. Participants’ ages ranged from 21-57 (M=37.9) and 70% were male. Qualitative data was coded using Atlas.ti software. Three themes illuminated participants’ experiences with end-of-life calls: (1) How legally binding documents (e.g. Do Not Resuscitate [DNR] orders, Medical Orders for Life Sustaining Treatment [MOLST]) inform care; (2) Decision-making about foregoing or halting resuscitation (e.g. no hospitalization, death at home); and (3) Family care, support and education. The results suggest that EMS providers have critically important roles in upholding the wishes of seriously ill older adults and helping caregiving families through the end-of-life transition. Implications: Discussions about the meaning of legally binding documents (e.g. DNR, MOLST) and EMS calls are important in advance care planning.

End-of-Life Decision-Making in Canada: The Report by the Royal Society of Canada Expert Panel on End-of-Life Decision-Making

2011 ◽  
Author(s):  
Udo Schuklenk ◽  
Johannes J. M. van Delden ◽  
Jocelyn Downie ◽  
Sheila McLean ◽  
Ross Upshur ◽  
...  
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Royal Society ◽  
Expert Panel ◽  
End Of Life Decision ◽  
Life Decision

scholarly journals “What Would You Do?”: How Cat Owners Make End-of-Life Decisions and Implications for Veterinary-Client Interactions

Animals ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 1114
Author(s):  
Katherine Littlewood ◽  
Ngaio Beausoleil ◽  
Kevin Stafford ◽  
Christine Stephens
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
End Of Life ◽  
Companion Animals ◽  
Chronically Ill ◽  
Future Research ◽  
End Of Life Decisions ◽  
Life Decisions ◽  
End Of Life Decision ◽  
Life Decision

Cats are the most common companion animals in New Zealand. Advances in veterinary care means that cats are living longer and there are many older cats. End-of-life decisions about cats are complicated by owner–cat relationships and other psychosocial factors. Our study explored the ways in which end-of-life decisions were being made by owners of older and chronically ill cats in New Zealand and the role of their veterinarian in the process. Qualitative data were gathered via retrospective semi-structured interviews with 14 cat owners using open-ended questions. Transcripts of these interviews were explored for themes using template analysis and nine themes were identified. Four were animal-centered themes: cat behavior change, pain was a bad sign, signs of ageing are not good, and the benefits of having other people see what owners often could not. Five were human-centered themes: veterinarians understanding owners’ relationships with their cat, normalizing death, the need for a good veterinarian to manage end of life, veterinary validation that owners were doing the right thing, and a strong desire to predict the time course and outcome for their cat. End-of-life decision making is complex, and the veterinarian’s role is often poorly defined. Our owners appreciated the expertise and validation that their veterinarian provided but continuity of care was important. Future research aimed at exploring the veterinarian’s perspective during end-of-life decision making for cats would be a valuable addition to the topic.

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