Gina Bravo1, Lise Trottier2, Marcel Arcand3, Anne-Marie Boire-Lavigne4, Danièle Blanchette5, Marie-France Dubois6, Maryse Guay7, Julie Lane8, Paule Hottin9, Suzanne Bellemare2. 1. Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada; Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, Canada. Electronic address: Gina.Bravo@USherbrooke.ca. 2. Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, Canada. 3. Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, Canada; Department of Family Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada. 4. Department of Family Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada. 5. Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, Canada; Department of Accounting Sciences, Faculty of Business Administration, Université de Sherbrooke, Sherbrooke, Canada. 6. Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada; Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, Canada. 7. Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada; Charles-LeMoyne Hospital Research Centre, Longueuil, Canada. 8. Department of Coordination and Academic Affairs, University Institute of Geriatrics of Sherbrooke, Sherbrooke, Canada. 9. Department of Psychiatry, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada.
Abstract
OBJECTIVE: To test an intervention designed to motivate older adults in documenting their healthcare preferences in advance, and to guide proxies in making hypothetical decisions that match those of the older adult. METHODS: The trial involved 235 older adults, of which half were assisted in communicating their wishes to their proxy. Hypothetical vignettes were used at baseline and twice after the intervention to elicit older adults' preferences and assess their proxy's ability to predict them. RESULTS: By the end of the trial, 80% of older adults allocated to the experimental group had documented their wishes. Changes over time in mean accuracy scores did not differ between groups for any hypothetical situations, except when limiting the sample to dyads that were highly discordant at baseline. CONCLUSION: The intervention motivated a large proportion of older adults to express their preferences but had little effect on proxies' ability to predict them. PRACTICE IMPLICATIONS: Educational tools developed for this study will assist healthcare providers in helping older adults to record their wishes in advance. Clients must be informed of the challenge of making substitute decisions and of the need to discuss the amount of leeway the proxy should have in interpreting expressed wishes.
RCT Entities:
OBJECTIVE: To test an intervention designed to motivate older adults in documenting their healthcare preferences in advance, and to guide proxies in making hypothetical decisions that match those of the older adult. METHODS: The trial involved 235 older adults, of which half were assisted in communicating their wishes to their proxy. Hypothetical vignettes were used at baseline and twice after the intervention to elicit older adults' preferences and assess their proxy's ability to predict them. RESULTS: By the end of the trial, 80% of older adults allocated to the experimental group had documented their wishes. Changes over time in mean accuracy scores did not differ between groups for any hypothetical situations, except when limiting the sample to dyads that were highly discordant at baseline. CONCLUSION: The intervention motivated a large proportion of older adults to express their preferences but had little effect on proxies' ability to predict them. PRACTICE IMPLICATIONS: Educational tools developed for this study will assist healthcare providers in helping older adults to record their wishes in advance. Clients must be informed of the challenge of making substitute decisions and of the need to discuss the amount of leeway the proxy should have in interpreting expressed wishes.
Authors: Chetna Malhotra; Meibo Hu; Rahul Malhotra; David Sim; Fazlur Rehman Jaufeerally; Filipinas G Bundoc; Eric A Finkelstein Journal: J Gen Intern Med Date: 2020-02-26 Impact factor: 5.128
Authors: Sarah Nouri; Courtney R Lyles; Anna D Rubinsky; Kanan Patel; Riya Desai; Jessica Fields; Mindy C DeRouen; Aiesha Volow; Kirsten Bibbins-Domingo; Rebecca L Sudore Journal: JAMA Netw Open Date: 2020-12-01
Authors: Sun Woo Hong; Shinmi Kim; Yu Jin Yun; Hyun Sook Jung; JaeLan Shim; JinShil Kim Journal: Int J Environ Res Public Health Date: 2021-01-28 Impact factor: 3.390