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Centre for Policy on Ageing | |
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| Implementation of the Patient Self-Determination Act (PSDA) in nursing homes in New York City | | Author(s) | Mathy Mezey, Ethel Mitty, Michael Rappaport |
| Journal title | Journal of the American Geriatrics Society, vol 45, no 1, January 1997 |
| Pages | pp 43-49 |
| Keywords | Residents [care homes] ; Rights [elderly] ; Terminal care ; Law ; Social workers ; Nursing homes ; Social surveys ; United States of America. |
| Annotation | A survey of US social workers in 109 nursing homes and their knowledge of the Patient Self Determination Act (PSDA) is presented. Nearly all stated that they made what they perceived to be a `serious effort' to inform residents about advance directives (living wills) and to have residents execute directives (preferably a health care proxy). Social workers in most homes informed residents about directives through face-to-face discussion. Most homes, however, did not inform residents who were thought to lack decision-making capacity about their right to execute a directive. Only 37% of homes had written procedures to determine decision-making capacity; most relied on physician and social work assessments. Voluntary homes and other homes more likely to have an ethics committee were more assiduous in implementing the Act and in having written procedures. Residents' understanding concerning end-of-life decisions is likely to improve with the involvement of social workers. Concern is expressed that most homes do not have clear procedures for determining residents' cognitive capacity to execute a directive. There is a need to replicate the benefits of those homes with ethics committees in implementing PSDA in other homes. (RH). |
| Accession Number | CPA-970812235 A |
| Classmark | KX: IKR: LV: VR: QR: LHB: 3F: 7T |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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