Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 65, Issue 3, Pages e70-e75Publisher
WILEY
DOI: 10.1111/jgs.14711
Keywords
decision-making; end-of-life care; qualitative research; sense of control
Categories
Funding
- John A. Hartford Foundation/Building Academic Geriatric Nursing Capacity predoctoral scholarship
- S. D. Bechtel Jr. Foundation/UCSF Program for the Aging Century
- National Institute on Aging [NIA 1K23AG040772]
- American Federation for Aging Research
Ask authors/readers for more resources
ObjectivesTo explore how older adults in the community with a limited life expectancy make healthcare decisions and the processes used when they are not in an acute crisis. DesignGrounded theory. SettingMedical programs and geriatrics clinics at the University of California, San Francisco, and the San Francisco Veterans Affairs Medical Center. ParticipantsCommunity-dwelling adults aged 67 to 98 with a life expectancy of less than 1 year (N = 20). MeasurementsIn-depth semistructured interviews in participants' homes. Constant comparative analysis was used to develop codes and identify themes. ResultsParticipants generally delegated decisions to others, expressing their wishes by describing desired end-of-life outcomes and highlighting meaningful aspects of their lives. They did this in the belief that the delegate would make appropriate decisions on their behalf. In this way, participants were able to achieve a sense of control without being in control of decisions. Four themes emerged from the analysis that reflect the various approaches participants used to articulate their goals and maintain a sense of control: direct communication, third-party analogies, adaptive denial, and engaged avoidance. ConclusionThese findings challenge the prevailing view of personal autonomy. These older adults suggest a path to decision-making that focuses on priorities and goals, allowing them to take a more-passive approach to decision-making while still maintaining a sense of control.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available