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Centre for Policy on Ageing | |
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Assessing capacity to participate in discussions of advance directives in nursing homes
— findings from a study of the Patient Self Determination Act | | Author(s) | Elizabeth Bradley, Leslie Walker, Barbara Blechner |
| Journal title | Journal of the American Geriatrics Society, vol 45, no 1, January 1997 |
| Pages | pp 79-83 |
| Keywords | Residents [care homes] ; Rights [elderly] ; Mental health [elderly] ; Terminal care ; Law ; Nursing homes ; Evaluation ; United States of America. |
| Annotation | Compliance with the PSDA (Patient Self Determination Act) requirement to provide written information about advance directives was assessed for some 600 residents randomly selected from 6 randomly chosen nursing homes and 19 key informants selected from 5 purposely sampled nursing homes in Connecticut (CT, US). Compliance with the PSDA requirement to provide information at admission is high (90.7% had received information within one week of admission). However, in nearly 70% of such cases, someone other than the resident had received the information. Staff often cited the resident's cognitive impairment as a reason for exclusion from this informing process. Even among those judged to be alert at admission, someone else received the information 47% of the time. Substantial numbers of residents may thus be excluded from participating in discussions because of difficulties in determining decisional capacity to discuss future treatment wishes. The research highlights the difficulties of enhancing resident participation and autonomy in long-term care through procedural regulations such as the PSDA; and more reliable methods of determining cognitive capacity are needed. (RH). |
| Accession Number | CPA-970812239 A |
| Classmark | KX: IKR: D: LV: VR: LHB: 4C: 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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