AI Article Synopsis
- Family decision-making roles shift significantly as cognitive impairment progresses, especially when elders can no longer make their own choices.
- Most families designate a primary decision-maker, but conflicts can arise, diverting focus from the elder's needs to managing disputes within the family.
- When family conflict occurs, the elder’s previously expressed wishes, particularly regarding end-of-life care, are less likely to be respected.
Article Abstract
Changes in family decision making responsibilities occur with progression of cognitive impairment. Focus groups with family members of nursing home residents with advanced cognitive impairment investigated values and beliefs used in making decisions for the elder. Family members described difficult decisions they had made to date, noting a significant transition in their decision making role when the elders' decisions needed to be superseded (especially with changes in living arrangements). In most families, one person or couple assumed the principal decision making responsibility. When decisions were made in the context of family conflict, managing the conflict became the focus, rather than the elder's care. In such cases, the elder's previously stated wishes regarding end of life care were not as likely to be honored.
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| http://dx.doi.org/10.1097/WAD.0b013e318030840a | DOI Listing |
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