Selection of a surrogate for end-of-life decisions is just the starting point for effective advance care planning.
Unprepared surrogates pose a major challenge for care teams, who face making treatment decisions without clear direction.
Surrogates struggle with guilt, stress, and doubt when they make decisions without knowledge of their loved ones’ wishes.
Health systems and hospitals can help equip surrogates to play their role.
Patients’ end-of-life surrogates are overly confident in their readiness to make crucial decisions for their loved ones, recent research shows.
Ill-prepared surrogates at the end of life are a vexing challenge for health systems and hospitals, with care teams often facing a heart-wrenching struggle to determine appropriate care plans in the absence of clear direction. Several studies have shown that surrogates are not well-acquainted with patient preferences, but patients believe that their loved ones already know their wishes.
The lack of surrogate knowledge takes a heavy toll on loved ones when life-or-death decisions arise, researchers wrote recently in JAMA Internal Medicine. “Substantial proportions of surrogate decision makers who have made end-of-life decisions experience burden, expressing stress, guilt, and doubts about having made the right decision.”