Making Critical Health Care Decisions for Older Adults: Consensus among Family Members

1999 ◽  
Vol 48 (2) ◽  
pp. 167 ◽  
Author(s):  
Karen A. Roberto
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Family Members ◽  
Health Care Decisions ◽  
Critical Health Care

scholarly journals “At 80 I Know Myself”: Embodied Learning and Older Adults’ Experiences of Polypharmacy and Perceptions of Deprescribing

2019 ◽  
Vol 5 ◽  
pp. 233372141989561
Author(s):  
Alison Ross ◽  
James Gillett
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Lived Experiences ◽  
Knowledge Bases ◽  
The Body ◽  
Care Providers ◽  
Embodied Learning ◽  
Health Care Decisions ◽  
Depth Interviews

In response to the risks of polypharmacy for older adults, there are increasing calls for the development and implementation of deprescribing programs. This article examines the forms of expertise that inform older adults’ decisions about how to use medications given concerns over polypharmacy and a clinical focus on deprescribing. In-depth interviews with older adults found that diverse knowledge sources underpin decisions regarding polypharmacy and deprescribing. Findings indicate that this knowledge is formed through a lifetime of embodied learning—the production of relevant knowledge through lived experiences of the body. By way of this embodied learning, older adults possess individualized knowledge bases that inform health and health care decisions, especially regarding the use of medications. If deprescribing programs are to be embedded into standard preventive medical care of older adults, then it is valuable for health care providers to be aware of and take seriously the contribution of embodied knowledge.

scholarly journals Family health care decision making and self-efficacy with patients with ALS at the end of life

2008 ◽  
Vol 6 (3) ◽  
pp. 273-280 ◽  
Author(s):  
Marie T. Nolan ◽  
Joan Kub ◽  
Mark T. Hughes ◽  
Peter B. Terry ◽  
Alan B. Astrow ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
End Of Life ◽  
Shared Decision Making ◽  
Family Members ◽  
Shared Decision ◽  
Health Care Decisions ◽  
The Family ◽  
Care Decision ◽  
Made In

ABSTRACTObjective:Persons with ALS differ from those with other terminal illnesses in that they commonly retain capacity for decision making close to death. The role patients would opt to have their families play in decision making at the end of life may therefore be unique. This study compared the preferences of patients with ALS for involving family in health care decisions at the end of life with the actual involvement reported by the family after death.Methods:A descriptive correlational design with 16 patient–family member dyads was used. Quantitative findings were enriched with in-depth interviews of a subset of five family members following the patient's death.Results:Eighty-seven percent of patients had issued an advance directive. Patients who would opt to make health care decisions independently (i.e., according to the patient's preferences alone) were most likely to have their families report that decisions were made in the style that the patient preferred. Those who preferred shared decision making with family or decision making that relied upon the family were more likely to have their families report that decisions were made in a style that was more independent than preferred. When interviewed in depth, some family members described shared decision making although they had reported on the survey that the patient made independent decisions.Significance of results:The structure of advance directives may suggest to families that independent decision making is the ideal, causing them to avoid or underreport shared decision making. Fear of family recriminations may also cause family members to avoid or underreport shared decision making. Findings from this study might be used to guide clinicians in their discussions of treatments and health care decision making with persons with ALS and their families.

Reaching Acceptance

2013 ◽  
Vol 2 (4) ◽  
pp. 381-410
Author(s):  
Jennifer E. Ohs
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Well Being ◽  
Integration Theory ◽  
Health Care Decisions ◽  
Health Care Decision ◽  
Problematic Integration ◽  
Patterns Of Communication ◽  
Problematic Integration Theory ◽  
Care Decision

Health-care decisions at the latter end of the lifespan are meaningful communicative experiences that can have important consequences for the health and well being of older adults. Using problematic integration theory as a guiding framework, I examined patterns of communication involved with the personal health-care decisions of older adults. I conducted interviews with sixty-two older adults in the process of considering a major health-care decision. Thematic analysis revealed that as older adults attempted to integrate and make sense of incongruent information related to their health-care decisions, interactions with physicians, adult children, spouses, and friends were influential. Additionally, overcoming avoidance, managing uncertainty, and reaching acceptance emerged in the health-care decision experiences of older adults in ways meaningful for problematic integration.

Health Communication: Implications for Diverse Populations

2011 ◽  
Vol 18 (1) ◽  
pp. 12-19
Author(s):  
Amy Hasselkus
Keyword(s):  
Health Care ◽  
Health Communication ◽  
Negative Impact ◽  
Linguistically Diverse ◽  
Good Health ◽  
The United States ◽  
Poor Health ◽  
Health Care Decisions ◽  
Diverse Backgrounds ◽  
Health Related

The need for improved communication about health-related topics is evident in statistics about the health literacy of adults living in the United States. The negative impact of poor health communication is huge, resulting in poor health outcomes, health disparities, and high health care costs. The importance of good health communication is relevant to all patient populations, including those from culturally and linguistically diverse backgrounds. Efforts are underway at all levels, from individual professionals to the federal government, to improve the information patients receive so that they can make appropriate health care decisions. This article describes these efforts and discusses how speech-language pathologists and audiologists may be impacted.

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