School of Nursing, 38028National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Department of Nursing, 46615Taipei Veterans General Hospital, Taipei, Taiwan.
Am J Hosp Palliat Care. 2022 Sep;39(9):1061-1070. doi: 10.1177/10499091211052853. Epub 2022 Feb 10.
Family members often take the place of decision-making for elderly individuals. Previous studies showed that family members could not predict elderly individuals' thoughts about end-of-life care. The aims are to understand the differences and perspectives between elderly individuals and surrogates regarding end-of-life care. A mixed methods study comprising a cross-sectional survey and field notes analysis. Two geriatric wards in a veterans hospital located in northern Taiwan. Fifty-five pairs of elderly individuals and their surrogates. Life support preferences questionnaire and field notes. The quantitative data showed that the elderly individuals and their surrogates had proper consistency in cardiopulmonary resuscitation and surgery. However, their consistency was poor in antibiotics and nasogastric tube feeding. Four themes were identified in qualitative data: recognizing old age, struggling with hope and peace, worries and concerns, and control of life. Recognizing old age for both elderly individuals and their surrogates was critical. Elderly individuals and their surrogates may seek a ray of hope among aggressive treatments and struggle with hope and peace. A lot of worries and concerns were mentioned, including contextual concerns. Elderly individuals need to depend on their ability to control their life. The study highlights elderly individuals' and their surrogates' considerations for antibiotics and nasogastric tube feeding. Furthermore, elderly individuals expressed that it is different for making decisions for themselves or others; thus, future studies can further explore whether elderly individuals allow their surrogates leeway from their wishes.
家庭成员经常代替老年人做出决策。先前的研究表明，家庭成员无法预测老年人对临终关怀的想法。本研究旨在了解老年人及其代理人在临终关怀方面的差异和观点。一项混合方法研究，包括横断面调查和现场记录分析。台湾北部一家退伍军人医院的两个老年病房。55 对老年人及其代理人。生命支持偏好问卷和现场记录。定量数据显示，老年人及其代理人在心肺复苏术和手术方面具有适当的一致性。然而，他们在抗生素和鼻胃管喂养方面的一致性较差。定性数据中确定了四个主题：认识老年、为希望与平静而挣扎、担忧和关注、以及对生活的控制。老年人及其代理人都认识到老年是至关重要的。老年人及其代理人可能会在积极治疗中寻求一线希望，并为希望与平静而挣扎。提到了很多担忧和顾虑，包括背景相关的顾虑。老年人需要依靠自己的能力来控制自己的生活。本研究强调了老年人及其代理人在抗生素和鼻胃管喂养方面的考虑。此外，老年人表示，为自己或他人做决定是不同的；因此，未来的研究可以进一步探讨老年人是否允许代理人在他们的意愿之外留有回旋余地。
