Surrogate and Physician Understanding of Patients' Preferences for Living Permanently in a Nursing Home

Mattimore, Thomas J.; Wenger, Neil S.; Desbiens, Norman A.; Teno, Joan M.; Hamel, Mary Beth; Liu, Honghu H.; Califf, Robert M.; Connors, Alfred F.; Lynn, Joanne; Oye, Robert K.

doi:10.1111/j.1532-5415.1997.tb01508.x

Cited by 168 publications

(105 citation statements)

References 21 publications

(37 reference statements)

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“…Pressure on beds may preclude both older people and their carers from exercising a genuinely informed choice (Lundh et al, 2000). It is usually a family member who takes the lead in MCEVOY, J. P., APPLEBAUM, P. S., APPERSON, L. J., et al (1989a) Why must some schizophrenic patients be both the decision to seek and find a care home, but surrogates may frequently misunderstand patient preferences in relation to living permanently in a nursing home (Mattimore et al, 1997). The person undertaking the intervention should explain it and assess capacity, in this case the social worker involved.…”

Section: Discussionmentioning

confidence: 99%

Capacity assessments on medical in-patients referred to social workers for care home placement

Ripley¹,

Jones

Macdonald

2008

Psychiatr. bull.

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Aims and MethodsTo investigate the feasibility of a clinical algorithm to assess capacity and examine the relationship between its results and the assessments of capacity by others involved in the decision of a patient to permanently enter a care home from a medical ward.ResultsA total of 23 patients out of 38 (60.5%, 95% CI 44–77) had some mention of capacity in any type of record (medical, social work or nursing). At formal assessment 47% of older patients lacked capacity.Clinical ImplicationsThe absence of any recorded assessment in at least a third of patients is worrying, given the importance of the decision to the patients' lives and their financial status. It is to be hoped that the implementation of the Mental Capacity Act (2005) will rectify this situation.

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Section: Discussionmentioning

confidence: 99%

Capacity assessments on medical in-patients referred to social workers for care home placement

Ripley¹,

Jones

Macdonald

2008

Psychiatr. bull.

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“…17,18,21,[25][26][27][28][29][30][31][32] In such studies, individuals are asked what they would want for themselves in particular circumstances. Their loved ones or designated proxies are then asked to predict what the patient would have wanted.…”

Section: The Evidence Against Substituted Judgmentmentioning

confidence: 99%

“…A second line of research examines the concordance between a patient and his or her doctors, [14][15][16][17][18][19][20][21][22][23][24] or chosen surrogates. 17,18,21,[25][26][27][28][29][30][31][32] In such studies, individuals are asked what they would want for themselves in particular circumstances.…”

Section: The Evidence Against Substituted Judgmentmentioning

confidence: 99%

Substituted Judgment: The Limitations of Autonomy in Surrogate Decision Making

2008

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“…Nevertheless, the evidence is unclear as to whether HCBSs can fully substitute for nursing home care or significantly delay permanent nursing home admissions (Miller & Weissert, 2000). Moreover, most older adults prefer to avoid nursing home placement whenever possible (Bishop, 1999;Mattimore, Wenger, & Desbiens, 1997). Even among seriously ill older adults, 29% prefer to die rather than enter a nursing home (Mattimore et al).…”

mentioning

confidence: 99%

Determinants of Remaining in the Community After Discharge: Results From New Jersey's Nursing Home Transition Program

Howell¹,

Silberberg²,

Quinn³

et al. 2007

The Gerontologist

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Purpose: To inform states with nursing home transition programs, we determine what risk factors are associated with participants' long-term readmission to nursing homes within 1 year after discharge. Design and Methods: We obtained administrative data for all 1,354 nursing home residents who were discharged, and we interviewed 628 transitioning through New Jersey's nursing home transition program in 2000. We used the Andersen behavioral model to select predictors of long-term nursing home readmission, and we used Cox proportional hazards regressions to examine the relative risk of experiencing such readmissions. Results: Overall, 72.6% of the 1,354 individuals remained in the community, with 8.6% readmitted to a nursing home for long stays (.90 days) and 18.8% dying during the study year. Cox proportional hazards regression analysis showed that being male, single, and dissatisfied with one's living situation; living with others; and falling within 8 to 10 weeks after discharge were significant predictors of long-term nursing home readmission during the first year after discharge. Implications: Most of the factors predicting long-term readmission were predisposing, not need, factors. This fact points to the limits of formulaic approaches to assessing candidates for discharge and the importance of working with clients to understand and address their particular vulnerabilities. Consumers, state policy makers, nursing home transition staff, discharge planners, and caregivers can use these findings to understand and help clients understand their particular risks and options, and to identify those individuals needing the greatest attention during the transition period as well as risk-specific services such as fall-prevention programs that should be made available to them.

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Surrogate and Physician Understanding of Patients' Preferences for Living Permanently in a Nursing Home

Cited by 168 publications

References 21 publications

Capacity assessments on medical in-patients referred to social workers for care home placement

Capacity assessments on medical in-patients referred to social workers for care home placement

Substituted Judgment: The Limitations of Autonomy in Surrogate Decision Making

Determinants of Remaining in the Community After Discharge: Results From New Jersey's Nursing Home Transition Program

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