The health care proxy in the nursing home

Abstract

This study sought to examine factors associated with advance end-of-life treatment planning and the appointment of a health care proxy by elderly nursing home residents, as well as the role social workers play in this area. The type of study was cross-sectional, quantitative survey with a qualitative component.;The study was conducted with a convenience sample of 98 elderly residents in five nursing homes in New York City and the surrounding area, and 88 health care proxies/designated representatives for a total of 186 subjects. Data was gathered by the use of questionnaires that were presented to the subjects during face to face or telephone interviews. The data was analyzed through descriptive and inferential statistical tests.;The findings suggest that a desire for self-determination regarding one's health care may be associated with the completion of advance directives. The findings also indicate that the majority of the nursing home residents and many of the health care proxies/designated representatives demonstrated limited understanding of the most commonly utilized types of life-sustaining treatment, as well as limited knowledge of the role of a health care proxy. The findings further indicate that most of the nursing home residents did not communicate their end-of-life treatment preferences to their health care proxy/designated representative. In addition, the findings indicate that the social workers and other professionals at the nursing homes played a limited role in the advance end-of-life treatment planning process.