Veterans struggle to communicate end-of-life care wishes with surrogates

Even when older adults designate a surrogate to make end-of-life care decisions in their stead, these wishes are often poorly communicated or misunderstood, according to a new study published in the Journal of the American Geriatrics Society.

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For the study, researchers interviewed 350 veterans 55 years of age or older. Researchers conducted separate interviews with the individuals identified by the veterans as their decision-making surrogates. More than 40 percent of the patient-surrogate pairs said the veterans had not communicated their end-of-life care wishes to their surrogates. Additionally, only 20 percent of surrogates accurately responded to inquiries about the patient’s preferences regarding life-sustaining treatment.

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“You can’t assume advanced care planning achieves the goal of making sure the surrogate understands what the patient wants,” said Terri Fried, MD, a professor of geriatric medicine at Yale University in New Haven, Conn., and the study’s lead author. “Planning needs to include a facilitated discussion between the patient and the surrogate to make sure they are hearing each other and talking about things that are important to the patient.”

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